Advisory Council Meetings Transportation Form

Name: *

ADVISORY COUNCIL MEETINGS POLICY:

Clients will receive a gas card for attending the Advisory Council meetings. However, the gas cards will be issued once the meeting is adjourned. Clients will not receive gas cards prior to the start of the meeting. The gas cards will be given as supplemental reimbursement for cost incurred for travel to the meeting. The amount of the gas card will be based on the distance from the consumer’s home and/or city / county to the meeting facility.

Referred by: *

I clearly understand the Advisory Council Meetings policy and agree to the aforementioned guidelines. *