Required fields are marked with an asterisk*

Full Name*[text* fullname class:all-100 id:fullname]

Address*[text* address class:all-100 id:address]

City*[text* address-city class:all-100 id:address-city]

Province*[text* address-province class:all-100 id:address-province]

Postal Code*[text* address-postal-code class:all-100 id:address-postal-code]

Purpose of Travel*[text* purpose class:all-100 id:purpose]

Email*[email* emailrin class:all-100 id:emailrin]

Telephone*[tel* phone class:all-100 id:phone]

Travel Details

Destination[text destination-1 class:all-100 id:destination-1]

Home to Destination

Date of Departure*[date* departure-1 class:all-100 id:departure-1]

Time of Departure*[text* dept-time-1 class:all-100 id:dept-time-1]

Time of Arrival*[text* arr-time-1 class:all-100 id:arr-time-1]

Destination to Home

Date of Return* (yyyy-mm-dd)[date* return-1 class:all-100 id:return-1]

Time of Departure*[text* return-dept-time-1 class:all-100 id:return-dept-time-1]

Time of Arrival*[text* return-arr-time-1 class:all-100 id:return-arr-time-1]

Travel Expense
Please only enter numbers

Air or rail (receipts required)[text airail class:all-100 class:field-01 class:field-sum id:airail placeholder "$0.00" ]

Accommodation (receipts required)[text accom class:all-100 class:field-02 class:field-sum id:accom placeholder "$0.00" ]

Car Rental (requires prior approval and receipts)[text rental class:all-100 class:field-03 class:field-sum id:rental placeholder "$0.00" ]

Parking, taxis (receipts required)[text parktaxi class:all-100 class:field-04 class:field-sum id:parktaxi placeholder "$0.00" ]

Baggage Fees[text baggage class:all-100 class:field-16 class:field-sum id:baggage placeholder "$0.00" ]

Private motor vehicle (km x $0.40)

km[text km class:all-100 class:km-field class:field-sum id:km placeholder "0"]

Gas[text gas class:all-100 class:km-field class:field-sum class:field-05 id:gas placeholder "$0.00"]

Meals
Please only enter numbers

Full Day ($51.00 per)

Days[text fullday-number class:all-100 class:pre-field-09 class:field-sum id:fullday-number placeholder "0"]

Cost[text fullday class:all-100 class:field-09 class:field-sum id:fullday placeholder "$0.00"]

Breakfast ($14.00 per)

Meals[text breakfast-number class:all-100 class:pre-field-06 class:field-sum id:breakfast-number placeholder "0"]

Cost[text breakfast class:all-100 class:field-06 class:field-sum id:breakfast placeholder "$0.00"]

Lunch ($15.00 per)

Meals[text lunch-number class:all-100 class:pre-field-07 class:field-sum id:lunch-number placeholder "0"]

Cost[text lunch class:all-100 class:field-07 class:field-sum id:lunch placeholder "$0.00"]

Dinner ($22.00 per)

Meals[text dinner-number class:all-100 class:pre-field-08 class:field-sum id:dinner-number placeholder "0"]

Cost[text dinner class:all-100 class:field-08 class:field-sum id:dinner placeholder "$0.00"]

Incidentals ($10 per / Canada) ($20 per / Outside of Canada)
This may be claimed for every night spent away from home, while travelling. [text inci class:all-100 class:field-10 class:field-sum id:inci placeholder "$0.00"]

Administrative Expense
(Original Receipts Required), Please only enter numbers

Postage[text postage class:all-100 class:field-11 class:field-sum id:postage placeholder "$0.00"]

Telephone[text extelephone class:all-100 class:field-12 class:field-sum id:extelephone placeholder "$0.00"]

Printing and Photocopy[text photocopy class:all-100 class:field-13 class:field-sum id:photocopy placeholder "$0.00"]

Stationary and Supplies[text stationary class:all-100 class:field-14 class:field-sum id:stationary placeholder "$0.00"]

Other[text other class:all-100 class:field-15 class:field-sum id:other placeholder "$0.00"]

Description[textarea textarea-723 class:all-100 id:textarea-723 ]

Total Expenses Claimed*[text* total class:all-100 class:field-total id:total placeholder "$0.00"]

Attach Receipts

[checkbox num-receipts class:num-receipts use_label_element exclusive "I have 5 receipts or less." "I have more than 5 receipts."]

Upload your receipts here. Maximum size per receipt 1.5MB.

Receipt 1:[file receipt-1 limit:1536kb filetypes:gif|png|jpg|jpeg|pdf|doc|rtf class:receipt-1 id: receipt-1]

Receipt 2:[file receipt-2 limit:1536kb filetypes:gif|png|jpg|jpeg|pdf|doc|rtf class:receipt-2 id:receipt-2]

Receipt 3:[file receipt-3 limit:1536kb filetypes:gif|png|jpg|jpeg|pdf|doc|rtf class:receipt-3 id:receipt-3]

Receipt 4:[file receipt-4 limit:1536kb filetypes:gif|png|jpg|jpeg|pdf|doc|rtf class:receipt-4 id:receipt-4]

Receipt 5:[file receipt-5 limit:1536kb filetypes:gif|png|jpg|jpeg|pdf|doc|rtf class:receipt-5 id:receipt-5]

Please upload all your receipts in one .zip file. Maximum file size 15MB.

Receipts in a .zip file:[file receipt-zip limit:15mb filetypes:zip class:receipt-5 id:receipt-zip]

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