Reimbursement Request for Substitute Teacher and Transportation Costs

To request reimbursement for the cost of substitute teachers and/or transportation, please use our online request form.  Reimbursements will be mailed out on a rolling basis.

Requests for large reimbursements may be granted partially at the Event Coordinator’s discretion.

Reimbursements requested less than two weeks before your event start date will be granted at the Event Coordinator’s discretion. Checks will be issued no sooner than the end of the event.

If you are requesting a reimbursement but don’t know the exact value, please submit an estimate before the event and check the box labeling it as an estimate. We will request that you fill out another request form when you have your final number.

Reimbursement Request - Substitute Teacher and Transportation

School Name *

Teacher Name *

Event requesting reimbursement for * Shasta (9/25-28/2024)Santa Cruz (10/9-12/2024)El Dorado (10/23-26/2024)San Bernardino 1 (11/6-9/2024)San Bernardino 2 (11/13-16/2024)

Number of days for substitute teacher *

Rate of pay per day per substitute teacher *

Cost of school vehicle for transportation *

Total Amount *

Total of requested Substitute Teacher and Transportation reimbursements

This is a(n):

Estimate

Final Value

Who should check be made payable to? *

When is payment needed by? *

Where should check be mailed?

Address *

Address

Address

Address

City

City

State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

State/Province

Zip/Postal

Zip/Postal

Any additional information or comments:

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