Post-Event Reimbursement Form

Submit within 30 days of the event ending.
A minimum of 15 hotel room nights is required.

Step 1 of 6

Certification*
- I certify that the information submitted in this application is factually true and correct to the best of my knowledge. I further understand that any false statements may result in denial or revocation of funding.
Contact Information
First Name*
Last Name*
Title*
Phone*
Email*

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Organization Information
Name*
Phone*
Website*

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Event Information
Event Name*
Event Start Date*
Month
Day
Year
Event End Date*
Month
Day
Year
Check all that apply:
- OAC Funding
Total Event Budget*
Please enter a number greater than or equal to 0.

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Calculated Eligible DTPID Funded Amount Based on Actualized Performance
Post Event DTPID Estimation Choice:*
Use the SAME method of computing the actual incremental room night code
Actual total number of attendees of the event
multiplier = .09
Please enter a number from .09 to .09.
Actual number of trackable hotel room nights through hotel booking codes
multiplier = 1
Please enter a number from 1 to 1.
Actual total number of ticket sales sold or registrations from outside of the DFW Metropolitan Statistical Area (MSA)
multiplier = .6
Please enter a number from .6 to .6.
Hidden
Post App ROI Coefficient - Final
Amount*
Please enter a number greater than or equal to 0.
Total Hotel Room Nights
Average Room Rate or Your Booking Code Rate*
Enter $168 or your Booking Code Rate
Please enter a number greater than or equal to 0.
Average Room Rate
Hidden
Post App Hotel Room Rate
Total Revenue
Hotel Room Nights multiplied by Average Hotel Rate
Final Eligible DTPID Amount*
Total Revenue divided by 10
DTPID Funds Pre-Approved (as stated in approval letter)*
You may receive funds only up to the amount for which you were pre-approved.
Please enter a number from 0 to 25000.
Hidden
Final Eligible - Pre-approved =
Let's see which is lowest by providing a positive or negative value which we can use for conditional displays
Hidden
Final Eligible as a % of Total Budget
Hidden
Pre-approved as a % of Total Budget
Subtotal
Your Final Eligible Amount is less than your DTPID Pre-approved Amount. So, you will receive your Final Eligible DTPID Amount.
Subtotal
Your DTPID Pre-approved Amount is less than your Final Eligible DTPID Amount. So, you will receive your DTPID Pre-approved Amount.
Subtotal
Your Final Eligible DTPID Amount is equal to your DTPID Pre-approved Amount. So, you will receive your Final Eligible DTPID Amount.
Subtotal
Your reimbursement would be more than 35% of your total budget. So, you will receive 35% of your total budget.
Hidden
Subtotal for Salesforce
Less Any Advance Payment (Non-Profit Organizations)
Please enter a number from 0 to 25000.
Final Amount You Will Receive

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How You Spent the DTPID Funds
Make sure that "Total DTPID Funds Available" is equal to "Total DTPID Funds Allocated". Use all fields that apply.
Total DTPID Funds Available
Event Marketing
Please enter a number greater than or equal to 0.
Event Staffing
Please enter a number greater than or equal to 0.
Event Production
Please enter a number greater than or equal to 0.
Other
Other Amount
Please enter a number greater than or equal to 0.
Total DTPID Funds Allocated
Must Match your Total DTPID Funds Available

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Brief Event Actual Results*
Please add additional information to "tell the story"
Describe how DTPID funds were used to increase attendance*
Applicant, when submitting this Event Application Package, acknowledges the information contained herein as accurate and agrees to review of all related event materials and final support documentation prior to DTPID payment.

If you have any questions, please contact Maribeth Lysen at (214) 571-1028 or Maribeth@dallastpid.com

Please send the supplemental documents as an attachment to Maribeth@dallastpid.com

Print this screen for your records before submitting. (Control+P or Command+P)
Hidden
Today's Date
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

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Step 1 of 6

Contact Information

Organization Information

Event Information

Calculated Eligible DTPID Funded Amount Based on Actualized Performance

How You Spent the DTPID Funds