Please enable JavaScript in your browser to complete this form.Consultant Name *PTSJulie StevensBrent BlackburnDave ClossonKendra TapieMitchell MooreRuby MoseleySandra Del SestoConsultant Email *Date of Service *Service was performed *OnlineOnsiteOnsite CityOnsite StateOnline Services *Online PresenterOnline TechnicianAdministration/ Web TechName of Online Event *CPS Prep CourseFacilitation & Presentation SkillsSpring ConferenceFall ConferenceATOD SpecificEthicsAdvanced EthicsPS Competency TrainingSupervision ConferenceMaster Trainer CourseOtherName of Other Online Event *# Presentation Hours# Online Technician HoursMeeting or Onsite Service *MeetingOnsite FacilitatorOnsite AssistanceOnsite Administration/ Web TechOther Service# Administration/ Web Tech HoursTotal # Paid RegistrantsOnsite Meetings *AdministrativeBoardConsultantMarketingProgrammaticOtherOther Meeting Name *Onsite Facilitation HoursOnsite Assistance HoursOther Onsite ServiceName of Service ProvidedOther Onsite Service HoursService FeeTravel/ Supplies/ OtherMileageLodgingMealsAirfareParkingGround TransportationSuppliesOtherSelect all that applyLayoutTotal MilesEnter total miles traveled, Reimbursement will auto generate at current GSA rate of $0.67Mileage ReimbursementLodging Total $Current Texas standard rate is $107 (plus taxes) A copy of the receipt is requested. Meals Total $Current Texas standard rate is $59. Austin is $64 Meal rates can be used from https://www.gsa.gov/travel/plan-book/per-diem-rates if you do not want to upload a receipt. Airfare Total $Parking Total $Ground Transportation Total $LayoutSupplies Total $Supplies DescriptionLayoutOther Expenses Total $List Other ExpensesPayment UsedCredit CardCashPTS CheckCard(s) Used6934922809636991100785701003Hyatt, AA, SW, IHG, Amx, Disc, HiltonCheck NumberTravel/ Supplies/ OtherTotal ReimbursementReceipt Upload Click or drag files to this area to upload. You can upload up to 6 files. Upload receipts here if lodging or meals are in excess of current GSA rates. File types accepted are png, gif, jpg, doc or pdf files onlySignature * Clear Signature Comments or QuestionsSubmit
