Non-UW Regional Traveler Reimbursement Form

This form is for regional travelers who are not employed by the UW.

UW-employed travelers should complete the Network’s web form.

Please have receipts prepared to submit. Receipts are required for expenses over $75, airfare, lodging, ride shares and taxis, and car rentals.

Traveler Information

Name *For check

Email Address *

Program

Mailing address for check *

Event Information

Event Name *

Event Type *ConferenceFellowshipHybrid Course

Note: we are not able to offer meal per diem to fellows and lead residents. Please leave this section blank on the non-employee claim form.

Claim Form

All travelers who are not paid UW employees must fill out and submit the UW NON-EMPLOYEE TRAVEL CLAIM FORM

To prevent reimbursement delays, the form must be filled out in its ENTIRETY including start/end times, personal time not taken, and citizenship status. Not all questions are relevant to our travelers but it is a UW requirement that all questions be answered. We cannot process a reimbursement if the form is incomplete.

Please note the Seattle meal per diem rate below. If you are traveling outside of Seattle, please leave this section blank and note what meals you want reimbursed in the comments below.

UW Per Diem Rates for Seattle (October 2025-September 2026)

Breakfast	Lunch	Dinner
$23.92	$26.68	$41.40

Non-employee Travel Claim Form *

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Itemized Receipts

Drag and Drop (or) Choose Files

Required for airfare, lodging, car rentals, rides shares and taxis, and expenses exceeding $75. Receipts must be itemized. For car rentals, please include the final itemized rental agreement.

If you stayed overnight, was your lodging paid for on a personal credit card or directly by the Network? *I paid for lodging on a personal credit card.The Network paid for my lodging directly.Neither; I did not stay overnight.

CommentsPlease include anything else about your trip we need to know.

Form Completed *

I have filled out the claim form in its entirety, and have indicated "No" or "N/A" on any applicable fields.

Acceptance of Network Travel Policies *

Completion and submission of this form indicates your knowledge and acceptance of our travel policies.

Traveler Information

Event Information

Claim Form

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