Hoosier Explorers Online Trip Reimbursement Form

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Field Trip Fund Trip Reimbursement Form

Submit your reimbursement request after your trip.
  • School/District Name Attention to: Street City, State, & ZIP Code
  • Date Format: MM slash DD slash YYYY
  • Number of Hours Worked x Hourly Wage = Driver Cost
  • FICA + Social Security = Driver Benefits
  • Total Miles x Cost per Gallon of Fuel = Fuel Cost
  • Cost of Drivers + Cost of Benefits + Fuel Cost = Total Cost of Transportation
  • Drop files here or
    Accepted file types: jpg, gif, png, pdf, doc, docx.
    Pictures or Student Work Product Relating to Trip, Max 10 Files. (Permitted files types include, jpg, gif, png, pdf, doc, docx)
  • This field is for validation purposes and should be left unchanged.