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Thank you for attending the March for Life in Washington, D.C. Friday, January 19, 2024.
Please be sure to attach a digital copy of your receipts in order to be reimbursed for your expenses.
*If you are missing a receipt, you will need to fill out and attach an
Accounts Payable Department Missing Receipt Affidavit
and upload it with your expense report file.
Questions? Contact
marchforlife@nd.edu
Biographical Information
Title
*
Dr.
Esq.
Hon.
Mr.
Mrs.
Msgr.
Rev.
Sr.
First Name
*
Last Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Email
*
Affiliation
Academic Institution
*
Notre Dame
Saint Mary's College
Holy Cross College
Affiliation Type
*
Faculty
Staff
Graduate Student
Department
*
Transportation to Event Destination (upload a digital copy of transportation receipt at the end of form)
Mode of Transportation
*
Airline
ND Bus
Personal Vehicle
Rental Car
Point of Departure
*
🛈
Point of Return
*
🛈
Are you requesting Mileage Reimbursement?
*
Yes
No
Is Mileage Reimbursement for One-Way, Roundtrip, Roundtrip w/ different location?
*
One-Way
Roundtrip
Roundtrip w/ change of departure address
Roundtrip w/ change of destination address
Departure Date
*
+
Return Date
*
+
Departure Address
+
-
Destination Address
+
-
From address
*
🛈
To address
*
🛈
Are you requesting reimbursement for rental car?
*
Yes
No
Transaction Date
*
🛈
+
Number of days rented
*
Vendor
*
Agency
Alamo
Avis
Budget
Dollar
Enterprise
Eurodollar
General
Hertz
National Car Rental
Rent a Wreck
Sixt
Thrifty
City
*
Amount
*
Airline
*
Aer Lingus
Aero Mexico
Air Canada
Air France
Air New Zealand
AirTran Airways
Alaska Airlines
Alitalia Airlines
All Nippon Airways (ANA)
American Airlines
British Airways
British Midland
Continental Airlines
Delta Air Lines
Emirates
Horizon Air
JAL
Jet Blue
LOT Polish
Lufthansa
Northwest Airlines
Northwest Airlines Inc. / KLM
Qantas
Reno Airlines
Ryan Air
Sabena
SAS
Saudi Arabian Airlines
Singapore Airlines
SkyJet
Southwest Airlines
U.S. Airways
United Airlines
Virgin
WestJet
Ticket Number
*
Transaction Date
*
🛈
+
Trip End Date
*
+
Destination City
*
Ticket Amount
*
Comment
Lodging (upload a digital copy of lodging receipt at end of form)
Lodging
*
Hotel/Motel/Inn
Other
None
Lodging Location
*
🛈
Lodging Location
*
🛈
Check-in Date
*
+
Check-out Date
*
+
Number of nights
*
Are you splitting the room cost with another person?
*
🛈
Yes
No
Total Invoice Amount
*
Total to be Reimbursed
*
Comment
Additional Expenses
Do you have expenses to be reimbursed (other than flight/rental car/mileage/bus/lodging)?
*
Yes
No
Number of expenses for reimbursement
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Receipt (1)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (2)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (3)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (4)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (5)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (6)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (7)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (8)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (9)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (10)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (11)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (12)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (13)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (14)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (15)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (16)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (17)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (18)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (19)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Receipt (20)
Date
*
+
Expense Type
*
Transportation
Meal
Lodging
Other
Vendor
*
🛈
City
*
Amount
*
Receipt
*
Yes
No
Comment
Total Amount Requested for Reimbursement (excluding cost of transportation to event and/or lodging)
*
Total Amount Requested for Reimbursement (including cost of transportation to event and/or lodging)
*
Upload a digital copy of all receipts, including transportation to the event and/or lodging. If a receipt was not given, for example, if you rode the ND bus, please note in the comment box. (Receipts do not need to be scanned individually)
*Label your file with your
last name and M4L2024
🛈
Additional Comments
Submission Date Acknowledgement
I understand that if I submit my completed expense reimbursement form after February 5, 2024, I may incur personal tax implications.
*
Yes