Student Activity Reimbursement

Food orders are no longer eligible for reimbursement starting October 14th, 2022

All orders must go through the Food Order Form at least five days prior to the event date. Please refer to our FAQ (#7).

STOP! READ BELOW FIRST
Food orders are no longer eligible for reimbursement! SCOMSA reserves the right to partially or fully deny reimbursement to all food purchases. You are expected to make these purchases through the Food Order Form on our website. Purchases made prior to October 14th, 2022 are still eligible for reimbursement.
Student Information
Full Name (First Last)*
Email*
Student Address (reimbursement check will be mailed here)*
Street Address Address Line 2 City State ZIP Code

Make sure you have access to this address for the next 6-8 weeks!
Activity Information
Student Group(s) Hosting Event*
Type "individual" if this was not group related spending
Event Name*
Event Date*
MM
DD
YYYY

If this was not for an event please type the date the activity ocurred or when the supplies was distributed/used.
Confirmation of Student Activity Calendar Post (.pdf or .jpg)*
Accepted file types: pdf, jpg.
This is required for any event that receives SCOMSA funding. Please note that this should be the Google Calendar and not the 25Live calendar.
Receipt/Reimbursement Information
SCOMSA Funding Approval Email (.pdf or .jpg)*
Accepted file types: pdf, jpg.
Type of Funding Used for Event*
- Semester Budget
- Adhoc
- SCOMSA Event
Note: 'SCOMSA Event' should ONLY be used by SCOMSA representatives. Student groups should not select this option.
Enter the Total Cost*
Expected amount you will receive from SCOMSA*
All ITEMIZED Receipts (PLEASE READ): Scan and upload ONLY ONE RECEIPT per .pdf or .jpg. PLEASE NAME FILES: "Last Name, First Name MM-DD-YY dollar.cents" (For Example: Doe, Jane 12-25-16 100.00)*
You must submit documentation that says some amount has already been paid. Your name, date, and the name of the vendor/business must be clearly visible on the receipt.
Drop files here or

Accepted file types: pdf, jpg.
Additional Documents
If your funding approval required you to submit additional documents, please attach them here. Otherwise, please skip this field.
Drop files here or

Accepted file types: pdf, jpg.
Please list all other sources and amounts of outside funding (includes out-of-pocket costs, department funding, grants, etc.)
Outside Source of Funding Amount
Additional Comments
Confirmation of proper receipts*
- I uploaded only itemized receipts with the proper file name format and with my name and the vendor's name visible. I understand that failure to follow these guidelines may delay my reimbursement.
Ineligible Reimbursements*
- This reimbursement is NOT for an Amazon, Gift Card, or Food purchase as I am aware those are all ineligible for reimbursement. If I purchased those myself anyways, I am aware that I will be expected to cover the cost myself.

Outside Source of Funding	Amount

Student Activity Reimbursement

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Student Information

Activity Information

Receipt/Reimbursement Information