Expense Voucher for All-State Committee Expense Voucher for Region/All-State Use this form to submit an expense voucher for SCBDA Members, Workers, and Services. Event Name(Required)Please select and event.Region 1 AuditionsRegion 2 AuditionsRegion 3 AuditionsRegion 4 AuditionsRegion 5 AuditionsRegion 6 AuditionsAll-State Band AuditionsAll-State Jazz Band AuditionsEvent Date(Required) MM slash DD slash YYYY Travel ExpensesAutomobile Travel FROMAutomobile Travel TODid you drive more than 90 miles one-way to this event?(Required) Yes No What is your one way mileage to this event?(Required)Enter a value.Was this trip a carpool?(Required)Did other directors ride in the vehicle with you? Yes No Please list the names of the additional person(s) in the carpool.(Required)To add additional names to this table, click the plus (+) sign at the end of the row.First NameLast Name Add RemoveEnter the number of ROUND TRIP miles.SCBDA Mileage Rate: .42 per mile. Round trip mileage for auditions is capped at $60.00. Please complete the form with all the pertinent information understanding that mileage will be capped at $60.00.This field is hidden when viewing the formMileage Rate(Required)Please enter a number from 0.42 to 0.42.Mileage Price(Required) Price: $0.00 This field is hidden when viewing the form90+ Mileage Rate(Required)Please enter a number from 0.42 to 0.42.90+ Mileage Price(Required) Price: $0.00 Mileage Cap Max Price: Other ExpensesDo you have any other eligible expenditures?(Required) Yes No Additional Expenditure 1(Required)Enter a description of the expense. Amount 1(Required)Enter an amount for this expense. Additional Expense 1 Receipt(Required)Please upload a receipt for this expenditure.Accepted file types: jpg, png, tiff, pdf, Max. file size: 5 MB. Do you have any other eligible expenditures?(Required) Yes No Additional Expenditure 2(Required)Enter a description of the expense. Amount 2(Required)Enter an amount for this expense. Additional Expense 2 Receipt(Required)Please upload a receipt for this expenditure.Accepted file types: jpg, png, tiff, pdf, Max. file size: 5 MB. Do you have any other eligible expenditures?(Required) Yes No Additional Expenditure 3(Required)Enter a description of the expense. Amount 3(Required)Enter an amount for this expense. Additional Expense 3 Receipt(Required)Please upload a receipt for this expenditure.Accepted file types: jpg, png, tiff, pdf, Max. file size: 5 MB. Professional Pay Stipend(Required) Price: TotalTotal Reimbursement Request Requester's InformationThe check should be made payable to:(Required)The check should be mailed to:(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email(Required)Please provide your e-mail address should we have a question during processing this voucher. Phone(Required)Please provide your phone number should we have a question during processing this voucher.