Submit AMEA Expense to Executive Director Submit for reimbursement. Obtain permission from the Executive Director before using this form. Name*Date* Position*Event*Home Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email MileageFromToFromToTotal Miles@.54 per mileHotel NameHotel ChargesAttach ReceiptMeals: (indicate the number of meals claimed)Breakfast ($10.00)Lunch ($15.00)Dinner ($20.00)Total Amount Meals Claimed:Miscellaneous Expenses (Attach Receipts below):Total Amount Miscellaneous Claimed:Attach ReceiptTotal Expense Claim:CAPTCHA
