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Eligibility Site Reimbursement Request
The Staff Development Center’s (SDC) goal is to make sure Eligibility Site end users are able to access the required training needed for eligibility determination. In order to ensure Eligibility Site end users are able to access the appropriate training, the SDC will reimburse Eligibility Sites for participants travel.

Here is what you need to know:

►Travel needs to be more than 60 miles from point of orgin to the SDC or other Certified Trainer Eligibility Sites
►SDC will reimburse lodging for each participant; guidelines will be sent to requester and participant once requests has been approved
►SDC will reimburse incidentals for each participant. In order to receive meal reimbursement, actual receipts will need to be provided.
►SDC will reimburse for Mileage; please encourage carpooling
►Requests are approved or denied based on funding available
►Completed invoices and receipts need to be received by the SDC within 2 weeks after the training is completed
►Travel reimbursement will be made directly to the Eligibility Site and not the individual

Please completely fill out this request form with the Requester and Participant(s) information. You only need to complete one travel reimbursement request form per class and can add multiple participants to the request. Once the request has been reviewed you will receive additional guidance on arranging lodging, per diem and mileage reimbursement.

Please submit your request at least 14 calendar days in advance.

Requester Information:
(Requester and participant can be the same person)
Requester Email: *
Your answer
Requester First Name: *
Your answer
Requester Last Name: *
Your answer
Requester Position Title: *
Your answer
Requester Organization: *
Your answer
Requester Phone: *
Your answer
Requester Special Accommodations Needed: *
Your answer
Participant Information:
Participant First Name: *
Your answer
Participant Last Name: *
Your answer
Participant Position Title: *
Your answer
Participant Email: *
Your answer
Participant Phone: *
Your answer
Reimbursement for mileage, lodging and per diem will be considered. Please provide the following for the Participant:
Title of the course(s) scheduled: *
Your answer
Date(s) scheduled: *
Your answer
Number of nights lodging: *
Your answer
Mileage estimate: *
Your answer
Statements of Understanding (Please Review and Check All Before Submitting): *
Required
Please submit a new form for each participant
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