Affiliate Reimbursement Subsidy Program
Please complete the form below for each event for which you wish to request a CUE reimbursement.

Program Details:
Affiliates may request reimbursement through May 30 for any allowable expenses incurred from events between July 1 and May 30 of the same fiscal year. These must be events previously posted on cue.org/events.

Affiliate treasurers (or their board designee) may request up to $500 per year in this fashion:

Each request must include a scanned, fully itemized receipt for the expense, and a separate form must be completed for each category of expense listed below.

The six categories of allowable expenses are:
1) keynote speaker honoraria or travel expenses (must not be a CUE or a CUE Affiliate board member)
2) online tool for tech fair or other affiliate event enhancement
3) event insurance,
4) room or equipment rental, including custodial expenses,
5) printing expenses, including programs, banners, handouts, and signage
6) election tool

CUE, Inc. will only issue reimbursement to the affiliate following receipt of a properly completed submission form for allowable expenses up to $500 per fiscal year, per affiliate. Payments will be issued to each affiliate within three months of submission for requested expenses.

Duplicate requests for reimbursement of the same expense will result in no reimbursement for that expense.

Please contact Jason Seliskar, Director of Affiliate Engagement with any questions regarding this policy at jseliskar@cue.org.

From time to time, the CUE Board of Directors may amend the list of allowable expenses.

Affiliate *
Name of affiliate contact (This should be the name of the person completing this form). *
Your answer
Email of affiliate contact (This should be the the person completing this form). *
Your answer
Position on affiliate board (Please share your role for this affiliate). *
Your answer
Physical Address to Send Check to: *
Your answer
Amount requested (NOTE: total receipts can exceed $500, but reimbursements will not exceed $500).
Your answer
Date of Affiliate Board Approval of request (Your affiliate board must have agreed to this request for reimbursement). *
Your answer
Name of event (What was the name of the event for which you are requesting a reimbursement (i.e. Cool Tools V, SGVCUE Tech Fair, etc.). *
Your answer
Please share the date of the event for which this request is being made. If your event covered more than one date, please select one of the inclusive dates. *
MM
/
DD
/
YYYY
Category of allowed expense *
Brief narrative explanation
Your answer
Please scan and upload all required receipts for this expense. Paste in the URL of the location of the file (google drive, dropbox, etc.). If there is no receipt that was received, please provide an explanation below. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of CUE. Report Abuse - Terms of Service - Additional Terms