Application for Mileage Reimbursement 23-24
                                           Elbert County School District C-2
                                
  PAYMENT WILL NOT BE MADE WITHOUT AN ACCURATE APPLICATION ON FILE.

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Please list the students from your household only; carpool/special situations need to be handled privately.

Mileage will be paid for a maximum of two round-trips per school day per household.

Mileage will be paid for half-time students at half the mileage reimbursement rate.

Mileage will not be paid:
   -For transporting students to and from extracurricular activities
   -to families living within one mile (one-way) of the school.

Monthly mileage calendars must be accurate and turned in by the date shown on each month's calendar.

Monthly payments will be mailed the day after the regularly scheduled board meetings.

Change of address must be in writing to the business office within 10 days of moving.

Mileage reports are available online at www.kiowaschool.org and in each school building.

Do you understand the above rules and requirements?
 *
Check Payable to (must be Parent or Guardian) *
Physical Address: Include City/Zip                        *
Mailing Address (if same as above, write "Same")
                                           
 *
Telephone Number: *
Email address for the Google Classroom: *
List the most direct distance from your residence to the school (nearest tenth of a mile)
Mileage may be checked against a mileage database at anytime.
 *
How many trips will be driven on a normal school day? *
I choose to be paid... *
List the Full Names of the Qualified School-Aged Children in your household and their GRADE. *
I hereby certify that the information  reported is accurate and that I have read the guidelines listed above. I am also aware that changes to my monthly reports will not be allowed after June 8, 2024.

Name of Parent/Guardian:


 *
Date: *
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