Alaska LTAP Professional Development Scholarship application

Alaska LTAP Professional Development Scholarship application

Application Form for Local Government Transportation Agencies
Use this form to request up to $3000.00 in reimbursement for Professional Development expenses. These expenses can include conference fees, airfare, ground transportation or hotel expenses. We cannot pay salary or per deim.

You must apply for and be PRE-APPROVED before the expense is incurred.
Name*

First NameLast Name
Total Scholarship Amount Requested *
There is a $3000 limit, even if expenses exceed this amount

Agency Information
Agency Name *
Department, Division, Section or Unit*
Title or Position*
Work or Cell Phone*
include area code
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List Active Public Roadway Transportation Projects (1 or 2 is fine)*
FAA, Airport, or Rural runway events or training do not qualify

Event Information
Name of Event*
Events Dates *
include travel dates
Location (where will the event take place?)*
How will attendance support the maintenance or development of public roadways in Alaska?*

Additional Information
Sharing information with the Alaska transportation community is a key requirement to use these development funds. Please specify how you plan to share learning outcomes and recommendations?*
Report, Teams meeting, other Webinar, another way?
Your organization or the individual requesting reimbursement must have an Alaska Vendor ID#.
- To create a Vendor account, go to the following Vendor Information page http://doa.alaska.gov/dof/vendor.html.
  - Under More Information select the W-9 Form and follow the directions to complete and submit the form.
- Email the completed form to the Vendor Help Desk doa.dof.vendor.helpdesk@alaska.gov or fax it to 907-465-2169.
If you are approved, once your travel is complete send a detailed invoice with receipts attached to dot.training@alaska.gov.
Should be Empty:

Agency Information