ALASKA OPERATING ENGINEERS/EMPLOYERS TRAINING TRUST

MILEAGE REIMBURSEMENT REQUEST

**Please be sure you have completed a STEP Grant Application prior to submitting this request**

***MILEAGE WILL BE VERIFIED VIA ON-LINE MAP SERVICE***

REQUIRED FIELDS**

Date Submitted**:

Class Attended**:

First Name**:     

Last Name**:

Mailing Address**:

City**:

State**:

Zip Code**:

**If physical address is the same as mailing address you must type in "same" to required fields**

(Checks will be mailed to the FULL Mailing Address) (FULL PHYSICAL ADDRESS IS REQUIRED FOR REIMBURSEMENT)

Physical Address**:

City**:

State**:

Zip Code**:

Phone Number**:          

Last 4 of  SSN**:

Date (driving to training)**:          

Start Odometer               

End Odometer     

Total Miles Driving TO Training**      

Date (driving home)**:              

Start Odometer               

End Odometer     

Total Miles Driving Home**       

MILEAGE TOTAL  **