Instructor Time Sheet & Expense Submission Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastLast 4 digits of SSN: *Email *EmailConfirm EmailNextClassSponsor / Location: *Training Conducted: *Vehicle Rescue (Basic / Refresher)Heavy RescueWinching, Moving, & LiftingFarm Emergency AwarenessFarm Tractor & MachineryGrain Bin Program (any)Silo Program (any)EMS Continuing Education (any)Administrative WorkOtherIf "administrative work" or "other", please describe here:If work was conducted over several days/times, please enter the current date under “Day #1 Date”.Date(s) and TimesDay #1 Date *Day #1 Total Hours *Day #2 DateDay #2 Total HoursDay #3 DateDay #3 Total HoursNextMileage and Other ExpensesDo you have mileage for this activity? *YesNoTotal "Round-Trip" Loaded MileageDo you have HAULING mileage for this activity? (Transfer of equipment, etc) *YesNoDo you have any other expenses related to this training? *YesNoWhat is the total sum of all expenses being submitted? *Please upload copies of receipts for these expenses (4 max). Click or drag files to this area to upload. You can upload up to 4 files. File formats that can be uploaded are ,pdf, .doc. jpg, .jpeg, or .png.PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
