Comstock Travel Grant Reimbursement Form
Grant Recipient First Name:
Grant Recipient Last Name:
Email:
Grant Reference ID:
20 Max Characters
Name of the conference or event:
Location of the conference or event:
Date of attendance:
Type of Expenses
Please select...
Hotel
Travel (plane/bus/train)
Tolls
Mileage
Is a receipt available?
Yes
No
Please describe the service or expense:
Total Miles Traveled
Total Expenses
AFTD can only reimburse up to $500 of your total expenses. If you have already requested a reimbursement AFTD can only pay up to the balance remaining on your grant.
Please upload your receipts.
Certification
Yes, I certify that the information is correct to the best of my knowledge.
AFTD is a non-profit, 501(c)(3), charitable organization. A copy of AFTD’s official registration and financial information may be obtained from the PA Department of State by calling toll free within Pennsylvania,1-800-732-0999. Registration does not imply endorsement.
Contact Information