National Computational Science Institute

NCSI Wish List Reimbursement Form

To receive reimbursement, submit this reimbursement form both electronically (using the submit button at the bottom of the form) AND via US mail. Print the form and send it, along with your receipt or a signed copy of your receipt, to the address below. We will reimburse up to $250 of approved expenses, less the value of any items already purchased for you by NCSI.

National Computational Science Institute
Shodor Education Foundation, Inc.
923 Broad St
Durham, NC 27705

Please send mail to ncsi-info @ computationalscience.org if you have questions or are not sure that your expense will be approved.

Name:

Mailing Address:

E-Mail Address:

Phone:

College/University:

Department Affiliation:

Which NCSI workshop did you attend?

What would you like to purchase? (Please give titles and authors when appropriate.)

How will this purchase benefit you in carrying out the ends of NCSI?

Were you able to attain matching funds? If so, how much and from where?

To whom should the check be written?

Where do we send the check?

----