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)

Phone

Phone

Reimbursement for mileage, lodging and per diem will be considered. Please provide the following for Participant #1.

Add another participant?

Phone

Reimbursement for mileage, lodging and per diem will be considered. Please provide the following for Participant #2.

Add another participant?

Phone

Reimbursement for mileage, lodging and per diem will be considered. Please provide the following for Participant #3.

Statement of Understanding: We understand financial assistance is considered on a case-by-case basis according to availability of funds and approval is not guaranteed.

Statement of Understanding: We understand that all requested travel documentation must be submitted within 2 weeks of course completion in order to be reimbursed.

Statement of Understanding: We understand that all travel arrangements need to be made in accordance with the guidelines outlined by the SDC.