2019 Burke County School District Network - Reimbursement Form Use this form to submit expense reimbursement requests related to your participation with PAGE Professional Learning. Session Dates (Please do not request a reimbursement prior to the actual date of the session.)*Select the session you wish to receive a reimbursement. September 9, 2019 October 22, 2019 February 14, 2020 March 9, 2020 Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code District* School / Location* Email* Enter Email Confirm Email Phone Number*Dinner Receipts (Enter total amount of all qualifying dinner receipts)Reimbursements will reflect uploaded receipts (maximum $25 per dinner which includes tax and 15% gratuity). PAGE does not pay for alcoholic beverages. Upload images of receipts (pdf, png, gif or jpg files accepted) Drop files here or Select files Accepted file types: pdf, jpg, gif, png, Max. file size: 50 MB. Number of Miles Traveled (driver only) MileageMileage is automatically calculated at the national average rate of .535 per mile. COMMENTS: If you have a comment or question, enter it here.TOTAL REIMBURSEMENT
