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Section A) Student Organization Information
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Enter the name of the student organization principal member who is submitting this form.
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Section B) Funding Information
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Funding Source *
What funding source has your student organization been approved for?
At least one funding source must be selected.
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Maximum Funding Amount *
$
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What is the total amount of the approved funding?
For example, if your organization was awarded $1000 in AS Funding and $500 in TCF, input $1500.00 as the Maximum Funding Amount.
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Section C) Tournament/Competition/Trip Information
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Is this a virtual tournament/competition? *
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For virtual tournament/competition, input the first date of the event.
For in-person tournament/competition, input the first date of travel to the event.
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For virtual tournament/competition, input the last date of the event.
For in-person tournament/competition, input the ending date of travel.
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For virtual tournament/competition, input "Virtual Tournament/Competition".
For in-person tournament/competition, input the travel origin (i.e. San Diego, CA)
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For virtual tournament/competition, input "Virtual Tournament/Competition".
For in-person tournament/competition, input the travel destination (i.e. Portland, OR)
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Section D) Payee Information for Tournament/Competition Participants Requesting Reimbursement
Download the Payee Information Form.
Complete the payee information and expense type breakdown for all tournament/competition participants requesting reimbursement from their approved funding source.
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Section E) Additional Tournament/Competition Participants
Provide a list the full legal name of all additional students who traveled and/or participated in this tournament/competition. You can either type the list in the box below or upload a file in the attachment section below. Either a typed list or an uploaded file is required.
These students will not request reimbursement.
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Type the list of additional participants here. Otherwise, upload a document in the section below.
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Will any student organization members be driving other UCSD students to the tournament/competition? *
If yes, your Fund Manager will contact you for additional information.
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Section F) Receipts
All corresponding documents and receipts must be uploaded in PDF format. Max file size of 2000 KB (2MB) per document. More than one document can be uploaded per section.
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For all receipts without the last four digits of the card number (e.g., Visa **** 1234), cash payment confirmation, OR balance due is not $0.00, please also upload a screenshot or image of the posted expense(s) as it appears in your bank account statement for verification purposes.
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Includes official receipts for airfare, lodging, registration, ground transportation, and insurance.
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All in-person, hybrid, and virtual events that involve physical activities (dance, exercise, etc.) must have event liability insurance.
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Group Leader Signature
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Review both statements. *
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If you would like to add any comments for your SLBO Fund Manager, please add them here.
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Note
If you do not receive a response from the Student Life Business Office (SLBO) within 10 days of your submission date, please follow up by forwarding your submission confirmation email to slboreimbursements@ucsd.edu to check on the status of your request.
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