Wellness Event Reimbursement

PLEASE NOTE: This is a taxable benefit. Reimbursement will be paid upon completion of the wellness event and submission of this reimbursement form. You must be a current employee at time of event to receive the reimbursement. If you are unsure if your event qualifies or for any additional questions, please contact GoUSF Wellness Program Manager, Suzy Kisylia, at skisylia@usfca.edu.

Full-time faculty and staff are eligible to receive a reimbursement of up to $100 in registration fees after participating in one wellness event (e.g. registration for athletic event, charity walk, wellness workshop, excludes any fitness classes or gym memberships) each calendar year.

To receive reimbursement, you must adhere to the following steps by December 1st of each calendar year that you are seeking reimbursement:

Submit a completed reimbursement form upon completion of the wellness event.
Submit your receipt, which shows proof of payment, via email (benefits@usfca.edu).

Employee Name

CWID (USF ID#)

Department

Event Name

Event Date

Registration Fee Amount

Certification

By entering my name and date below, I hereby certify that this expense was incurred on my own behalf and was not reimbursed by another source.

Employee Signature

Today's Date