Request for Travel Reimbursement Please use this form if you are a visiting Wesley Theological Seminary prospective student who is scheduled to visit us, or is registered for an upcoming open house event. You will receive your reimbursement 1-2 weeks after your visit. The asterisk ( * ) indicates a required field. Name* First Last Email* Mailing Address*Please enter your complete mailing address to ensure the receipt of your reimbursement check. Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Date of Event or Visit* Date Format: MM slash DD slash YYYY Event Attended*Please select the event that you attended from the drop-down menu.College DayProject Transformation WeekendWesley Fellows WeekWindow on WesleyWelcome TableWesley WeekendAdmitted Student DayCommunity Engagement Institute Event at Wesley DowntownOne-on-One campus visitWhich of the following travel expense are you requesting reimbursement:* Train (Amtrak, etc.) Airfare Ground transportation to/from airport Airport parking, up to one 24 hour period Public transportation Ground travel from home to Wesley's campus- Auto Mileage in excess of 50 miles each way Gas Purchase (may not be combined with auto mileage) Tolls Other/Not listed Email a copy of your travel receipt(s), maps, or itinerary (PDF or Word format preferred) to the following: firstname.lastname@example.org, subject line: "Travel Form"Enter round-trip mileage information here. (ex. 153 miles) or attach a copy of your online navigation information (ex. google maps) belowEnter any additional information (ie, Travel to/from, questions):Note: Wesley Theological Seminary offers 50% travel for prospective students traveling over 200 miles or more. Eligible expenses may include: 1) Airfare**. 2)Ground transportation to and from airport. 3) Airport parking for up to one 24-hour period. 4) Public transportation. 5) Car mileage in excess of 50 miles each way. **The Office of Admissions can purchase a flight(s) at a discounted cost. Contact our office for assistance with finding the best possible fare. The maximum allowable total reimbursement is $300, contact Marci Matthews, email@example.com if your request for assistance is greater than the maximum allowable dollar amount. ************************************************************************************* Note: Lodging & meal expenses cannot be reimbursed. (This does not include complimentary campus housing or Admissions hospitality related off-campus lodging (see more below). Food options are often provided at most of our on-campus events. Carpooling & ride sharing are strongly encouraged. Parking at our events is free of charge, request a parking pass for your one-day visit from the Office of Admissions. †Reimbursement requests are subject to approval. The traveler must obtain the required approval for flights and other forms of transportation exceeding $250/one-way prior to departure or prior to incurring expenses. We reserve the right to increase travel assistance based on situational circumstances and to refuse reimbursement for spending which exceeds the total estimated expenses or for requests that were not previously approved. NameThis field is for validation purposes and should be left unchanged.