Field Trip Travel Reimbursement Form

Request for Field Trip Travel Reimbursement Kittitas County 4-H Council

Due October 15th

After the 4-H club(s) have returned from their trip, a “Request for Travel Reimbursement” form is filled out and turned into the Extension Office. These requests are due by October 15th and given to the County 4-H Council Treasurer.
Before the November Leaders’ Council meeting, the 4-H Council Treasurer will divide the Field Trip Transportation money in the following manner:
- 1/5 is divided by the total number of clubs who turn in a “Request for Travel Reimbursement” form.
- 2/5 is divided by the total miles traveled by all clubs who turn in a “Request for Travel Reimbursement” form.
- 2/5 is divided by the total number of 4-Hers who participated in the field trips. Maximum of $200 per club.
Travel reimbursement is limited to vehicular travel within the Pacific Northwest (i.e., Washington, Oregon and Idaho).

Date:(Required)

Club Name:(Required)

Club Leader:(Required)

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone:(Required)

Date of Field Trip:(Required)

Field Trip Destination:(Required)

Educational Value of Field Trip:(Required)

Number of 4-Hers Attending:(Required)

Number of Leaders Attending:(Required)

Number of Vehicles:(Required)

Total Round-Trip Mileage:(Required)

Digital Signature:(Required)

Typing your name in this field constitutes a digital signature.