CAFP-Foundation: FMIG Reimbursement Form
California Family Medicine Interest Groups are eligible for up to $1,000 toward operating costs of FMIG activities with a specific purpose of advancing student interest in family medicine.
All events are possible thanks to funding provided by the California Academy of Family Physicians Foundation and the American Academy of Family Physicians. Please note that unspent funds do NOT rollover into the next academic year.
Complete the following information and submit the required documents for reimbursement.
Date of Event:
Next Event Date (if available):
FMIG Leader Name
FMIG Leader Email
California University of Science and Medicine
UC Los Angeles
UC San Francisco
UC San Diego
Number of students attended:
Number of faculty/staff attended:
Please provide a brief description of your event and indicate how it helped to advance student interest in family medicine.
Itemized list of expenses for reimbursement:
Total Cost of All Expenses
Make Check Payable to:
Address Line 1
Address Line 2
Copy of Receipts (please submit as a PDF if possible)
Photos from Event
Event Sign-In Sheet (please submit as a PDF if possible)
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