KCACTF Region V Respondent Reimbursement Form

Respondent's Name:
Respondent's Mailing Address:

Please check HERE if this is a new or changed mailing address

Respondent Email
Respondent's Phone Number:
Name of Production Seen:
Date Seen:
Site

KCACTF Region V reimburses mileage @ $.33 per mile.

Dinner is often provided by the host school. Meal costs, particularly those incurred during long trips, will be reimbursed. If you have receipts to submit (meals, toll roads, parking, etc.) please submit this form via US mail, rather than using this form, and include your receipts with the form. The mailing address for reimbursement material is:

Rick D. Anderson
Director of Theatre
Kirkwood Community College
6301 Kirkwood Blvd. S.W.
P.O. Box 2068
Cedar Rapids, Iowa 52406

Overnight lodging is to be paid by the host school. Accommodation should be expected- particularly if you are traveling beyond a ninety minute radius from home. Unexpected lodging needs (such as weather related) will be reimbursed.

Airfare or car rental will not be reimbursed without prior approval. KCACTF will not reimburse costs associated with traffic violations.
Total Round-trip Mileage: (Enter a NUMBER only)
Total Round-trip mileage x $.33:

(Enter a NUMBER only)
Other Travel Expenses (toll roads, airfare, parking, etc.) (Enter a NUMBER only)
Meals/Food (Any NOT covered by host school) (Enter a NUMBER only)
Description of Other Expenses, if any:
Total Reimbursement Due: (Enter a NUMBER only)