2024 Zozobra Department Stipends and Reimbursement Zozobra Stipend 2024 Name* First Last Email* Enter Email Confirm Email Enter the amount of your stipend from your appointment letter DO NOT MIX STIPENDS*** YOU MUST FILL OUT A FORM FOR EACH STIPEND if you are entitled to more than one*SPILT MY STIPEND WITH ANOTHER PERSON* YES NO IF YES TO A SPLIT ENTER THE NAME OF THE PERSON YOU ARE SPLITTING WITH First Last ENTER THE AMOUNT TO BE DEDUCTED FROM YOUR STIPEND TO GIVE TO THIS PERSONHave all your department's vendor bills been sent to [email protected] and CC'd [email protected] AND [email protected] or uploaded to your budget spreadsheet? DO NOT SUBMIT THIS FORM UNTIL ALL YOUR VENDOR'S INVOICES ARE SUBMITTED. THANK YOU* Yes Have your budget spreadsheet and invoices been linked? DO NOT SUBMIT THIS FORM TILL YOU HAVE COMPLETED YOURT BUDGETR WORKSHEET AND LINKED INVOICES . THANK YOU* Yes I will schedule my debrief as soon as the form comes out. I understand i will receive my stipend check (if any) at the conclusion of my debrief* Yes IF YOU HAVE RECEIVED A HANDBOOK – I IWLL BRINMG MY HANDBOOK TO MY DEBRIEF TO TURN IT IN Yes IF YOU DO NOT HAVE THIS ON FILE AND ARE RECIEVING A PAYMENT Upload your W-9 here https://www.irs.gov/pub/irs-pdf/fw9.pdf*Max. file size: 256 MB.Upload reimbursement form (RECEIPTS REQUIRED) Drop files here or Select files Max. file size: 24 MB. Department De-Brief Report* Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, Max. file size: 256 MB. How would you like your stipend paid?* Venmo Cash App PayPal Zelle Written check (will be sent Sept 23) Donate to club (NO TAX LETTER) Donate to Foundation (need to request Tax exempt letter from Lynette) Donate to Preservation (you will receive a tax exempt letter by Oct 1) If you chose Zelle, please enter your phone number belowif you chose check fill out below Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country I certify by signing below I will file all appropriate documents with taxing authorities*Date MM slash DD slash YYYY PLEASE BE PATIENT AFTER HITTING SUMBIT IT WILL TAKE A MINUTE OR TWO TO UPLOAD YOUR DOCUMENTS USE THE BELOW TO REQUEST YOUR PAYMENT
