Field Trip Transportation Reimbursement Form

District Name(Required)

Name

School Name(Required)

Name

IMPORTANT: Please allow 6-8 weeks for processing. Forms received after May 1st will be processed in August. No checks will be mailed during the summer unless arrangements are made with the OERB. If there is a problem with your reimbursement form, the OERB will contact you. If you have questions, email Teachers@OERB.com.

School Address(Required)

Street Address Address Line 2 City State ZIP Code

Are you submitting a Transportation Reimbursement form for a Home School Field Trip?(Required)

Yes

Federal ID Number(Required)

The FEIN is a # registered with the State of Oklahoma (similar to what you would find on a W-2 form from your school). The FEIN # will determine where the Transportation Reimbursement is sent. It is a 9-digit number (similar to ##-#######).

School Phone(Required)

Teacher's Name(Required)

First Last

Teacher's Email(Required)

Are you submitting a transportation reimbursement form for additional OERB trained teachers?(Required)

Yes

Other OERB Trained Teacher's Name(Required)

First

Last

Museum Visited(Required)

Museum Visit Date(Required)

Mode of Transportation(Required)

# of Students that Attended(Required)

# of Miles Traveled, Round Trip(Required)

Hidden

Cost per student(Required)

Total Invoiced Amount for Transportation

Auto-calculation: (# of Students that Attended) * (# of Miles Traveled, Round Trip) * $0.04

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Field Trip Transportation Reimbursement Form

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