Travel Assistance Reimbursement Request

Reimbursement Request Details

Travel assistance funds are intended only for the student's cost to travel and valid expenses include:
- Airfare
- Bus or Train fare
- Taxi or Rideshare (Lyft, Uber, etc.) or Rental car
- Mileage to and from HMC's campus (at a rate of $0.725 per mile)
- Lodging (hotel, Airbnb, etc.)
The use of any travel/airfare/lodging/Uber/Lyft points, credits, or gift cards as a form of payment for your travel will not be accepted for reimbursement.
Reimbursements are made via check and may take up to one month to process.
Reimbursements are reviewed and must align with your event registration details. HMC reserves the right to refuse reimbursement requests upon review.

For WISTEM Program Participants

To qualify for funds to assist with travel to HMC:

You must qualify for or participate in one of the programs below.
You must complete the travel assistance reimbursement request form by June 24, 2026.
You must check-in and participate in the WISTEM program on June 22, 2026.
Travel must be to and from Claremont, CA and within the United States and its territories
Maximum reimbursement amounts are based on the home address you indicated on the WISTEM registration form.
- 0 to 100 miles from campus - up to $100
- 101 to 250 miles from campus - up to $200
- 251 to 500 miles from campus - up to $400
- 500+ miles from campus - up to $500

Do you qualify for or participate in any of the following?

Yes

No

ACT or SAT testing fee waiver
Federal Free or Reduced Price Lunch program at school
Federal, state or local programs that aid students from low-income families (eg. TRIO programs such as Upward Bound)
Income Eligibility Guidelines set by the USDA Food and Nutrition Service
Are a ward of the state or an orphan, reside in a foster home, or are homeless
Public assistance

Note: For US Citizens and permanent residents, HMC does not consider a student's ability to pay for their college education in our admission decisions (i.e. need-blind). Furthermore, we commit to meeting full demonstrated need for all admitted students.

Student Information

Student First Name

Student Last Name

Student Preferred Name

Student Birthdate

Student Email Address
(Please do not use a family member's email address.)

Should the reimbursement check be made out for a person other than the student?

Yes

No

Reimbursement Recipient

First Name

Last Name

Reimbursement Recipient's Email Address
(Please do not use the student's email address.)

Mailing Address

Country

Street

City

Region

Postal Code

Reimbursement Documentation

Airline Receipt & Boarding Pass—For airline receipt, the student's name must be listed as a passenger. Receipts must be fully itemized and include the total cost.
Mileage Driven—For mileage driven, include a PDF of Google Maps showing the total miles driven to and/or from HMC (301 Platt Blvd., Claremont, CA 91711).

Upload documentation

Form Agreement

By checking this box and entering my name below, I are electronically signing this form.

Student Signature
First Name, Middle Initial (if applicable), and Last Name

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