OCFOA Mileage Request Form

OCFOA Mileage Request Form
Name

First NameLast Name
E-mail
Date of game

MonthDayYear
Game # (from Arbiter)
Home Team
Visiting Team
Level
Your starting Location is your home address if you live in Orange County. It does not matter if you left from your work location to travel to the game, mileage is only paid for the distance from your home to the game site and then back to your home. If you live outside of Orange County, then you are only paid for the mileage you traveled inside Orange County. List your entry point into the county(i.e. Seal Beach Blvd and the 405 fwy, Katella Ave and the 605 fwy. Valley View and the 91 fwy, etc) as your starting location. If you need help with this, contact Paul Caldera directly.
Starting Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Game Site

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Use Starting Location for Ending Location
Ending Location (home address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Google Maps give you an accurate mileage assesment of distance traveled. Enter your home address or entry point into Orange County as the starting location and the game site as your destination. To determine the mileage for your return trip, use the game site as your starting location and your home address as the destination. Add the two distances together to determine Total Mileage.

Please note the following:
- Mileage is for varsity games only.
- Submit no earlier than the Monday prior to the game.
- Use Google Maps or similar when determining mileage.
- Submitting for mileage after the game will not be honored.
Total Mileage
Mileage Payment
A copy of this request will be sent to Paul Caldera automatically. You will also receive a copy of the request. If after submitting this request, you decide to carpool to the game site, be sure to contact Paul directly and he will cancel the request for mileage reimbursement.
Should be Empty: