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> PT Legislative Impact Day Mileage & Parking Reimbursement Form
PT Legislative Impact Day Mileage & Parking Reimbursement Form
Thank you for attending PT Legislative Impact Day and submitting this form for mileage and parking reimbursement.
Requirements and Other Details:
Only PT and PTA students from Western Washington may be reimbursed for mileage and parking.
The PT or PTA student must be the driver of the vehicle.
Mileage and parking expense must be incurred on January 25, 2018.
At least four people who are attending PT Legislative Impact Day (including the driver being reimbursed) must be transported in the vehicle. Only the driver needs to be a student.
This reimbursement request must be received by March 26, 2018.
If you have any questions about filling out this form or the requirements, please contact
or call (800) 554-5569.
A reimbursement check will be mailed to you within 7-10 business days of PTWA receiving a completed reimbursement request.
Whatcom Community College
University of Washington
University of Puget Sound
Pima Medical Institute
Green River Community College
Mileage Starting Address
Mileage Final End Address
Total Mileage Requested
If total mileage amount is not requested, PTWA will calculate your mileage based on direct route travel between your starting address and final end address listed above.
Names of ALL Passengers/LID Attendees (Must be 4+ passengers)
Amount Paid for Parking
Please email parking receipt to
, if it is available.
By submitting this form, I attest that I meet all of the requirements as specified above and the information I am submitting is correct to the best of my knowledge.
208 Rogers St. NW
Olympia, WA 98502
360.352.7290 or 800.554.5569
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