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Welcome to the CBA Reimbursement Form

Below please find instructions for the CBA Member Reimbursement Form.

  • You can be reimbursed for up to $500 in travel expenses.  For many of you, your largest expenses (flight and hotel) may exceed the cap, so you will only need to submit your largest receipts.
  • Each submission on the form should match each receipt total.
  • Please submit actual receipts; screenshots of credit card statements are not sufficient.
  • If you submit mileage, please be sure to include a map (Google, MapQuest, etc.) of the estimated mileage as documentation.

If you have any questions about completing this form, please contact Liz Fossett

Your Name(Required)
Who should the payment be made out to?
What was the purpose of this trip or the reason for this reimbursement. IE did you travel to the 2022 conference.
You can enter up to 20 expenses on one form.

If entering an expense as other you must enter your reason in the notes field near the bottom of the form.

Date should be entered as month/day/year - example - 07/10/21 or 07/10/2022
Expense Type
Use The + Symbol to add more than one entry.
Mileage Tracker
Mileage (Only enter miles if not inputting gas receipts and/or rental fees).

You can enter up to 10 mileage entries below. More if you use Trip Count.

Please only use whole numbers for number of miles. Round Up to the next whole number (45.5 miles becomes 46 miles)

Route Name This is just a name for the trip. Say you drove from your house to the hotel. You would put something like Home to Hotel or Home to Conference in the route name.

Trip Count: Say you took the same route with the same mileage 5 times. Rather than enter that info 5 times, trip count allows you to enter that trip once then we multiply the miles by the trip count to get your total miles.
Route Name
Trip Count
Total Miles
Use The + Symbol to add more than one entry.
Please upload support for each expense (including route map for mileage). Please submit all receipts in one file when possible. If missing a receipt please let us know in the notes field below.
Drop files here or
Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 5 MB, Max. files: 10.