AFS Victoria Volunteer / Local Group Expense Claim Form (Do not use this form for Medical Expense Claims) Date: Name: Contact Phone Number: Contact Email Address: Hosted Students Name (if applicable): AFS Local Group: I would like to make a claim for (please tick one): Reimbursement Language or Other Program Advance Account for Payment Date Description of Expense Amount Total of Claim $ - Person to cheque to made payable to: Name: Postal Address: Local Group Use Only: This expense has been approved by an authorized Local Group Representative: Local Group Representative Name: Signature: Date: If the Claimant has no local group representative, the volunteer may make a to claim directly from State Funds for this particular claim, has either the State Chair or Vice-Chair approved the expense? YES NO Please send this form complete with all supporting documentation (i.e. original receipts, tax invoices, or budget forms, or fundraising approvals etc) to your Local Group Representative for Approval. (Please keep a copy) Discuss with your Local Group the policy of for claims which are not covered by the VIC State Funds. Payment of these claims may be deducted from Local Group Funds if it is the groups Policy. Fees not covered VIC State Funds include school subject fees other than the core subjects, additional travel costs other than school bus, purchasing of school uniforms, school trips, school camps & food, year books, deposits on hire items, text book purchases / stationary and gifts. Medical Claims are to be forwarded direct to AFS Sydney. Local Group Rep to forward this form along with all supporting documentation to the State Treasurer. Incomplete forms will be returned to the Local Group. State Treasurer Use Only: Date: Date: Received: Processed: Cheque N#: Acknowledged: Acknowledged: Signature: State Treasurer - AFS Victoria Paul Centofanti Post: 1/41-43 Union Street Email: email@example.com Kyabram VIC 3620 Phone: 0419 541 781 a9d0091a-88d1-412d-b0cf-7077b686fd82.xls PAYMENT OF HOST STUDENT EXPENSES Who Pays for What Medicare/AF Paid By AFS Check with your Local S Sydney Paid By Student Paid By Paid by Group Hosts Notes VIC Item Personal All personal expenses e.g. toiletries, clothes, shoes, hairdresser etc X Public Transport costs for private purposes X Extra curricular sporting costs & Equipment X Personal & independent entertainment, e.g. Movies X Extra meals, snacks no arranged by host family X Postage X School School Levies for core subjects X School Levies for Special Courses, e.g. optional sports, Marine Studies X Uniforms, Shoes & Swimmers X X Note 1 Bicycle & Helmet X X Note 1 Public Transport to and from School X Compulsory School excursions & camps excluding food X Non Compulsory School excursions & camps X School mainstream sport excluding optional sports X Text Book / Calculator Hire X Deposits on Text Books & Calculator Hire X Text Book Purchases (must be credited to AFS local group at Completion) X X Note 2 Stationary Purchase X X Note 2 Home Economics Ingredients & Trades materials (wood & metal working) X Year Book X Medical Doctors / Hospital Visit & Pharmacy (Must have Medical form completed by Doctor) X Note 3 Other Regular Snacks & Meals as arranged by family X Note 4 Entrances when attending as a family X Note 4 Travel as part of a family X Note 4 Note 1: Some AFS Local Groups have bicycles, school uniforms and shoes available for Student usage. Check with you local group. Small rental fee or deposit may be required. Note 2: Local Group may also elect to pay for purchase of text books, however these remain the property of the local group. If Text books are purchased back by the school, proceeds remain with the local group. Local group may also elect to pay for stationary needs. Check with your local Group. Note 3: All Medical claims must have a AFS Medical form signed by the attending Doctor. A claim is first made with MediBank, who will refund part of the costs. AFS Sydney will then arrange for payment for the difference. All paperwork, invoices and receipts are to be sent direct to AFS Sydney. Keep copies of all paperwork. Note 4: Typical Only. Up to individual families and students General: All claims (except medical) to be submitted on AFS VIC expense claim form and forwarded to your local group for approval. All paperwork is to be attached. The local group representative will identify those expenses which are student responsibility, local group responsibility or AFS VIC responsibility. Local group representative to approve for payment and forward to the State Treasurer / Committee for payment.