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State of Wi Forms

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					                                 INDIVIDUAL EVENT ATTENDANCE APPLICATION
                                      Wisconsin RTAP Scholarship Program
                                                     Wisconsin Department of Transportation
                                                               DT2280     5/2011

To use this electronic fill-in form, place your cursor inside the field of the first fill-in blank below (the
Agency/Organization field). Use the tab key to move from one field to the next. Use the mouse to fill in check boxes.
All math calculations will be automatically performed. A handwritten signature is not required.
Upon completion of data entry, save the completed form to your computer. Then click on "File" and, from the
dropdown, select “Send To”, and “Mail Recipient (as Attachment)”.
Applications must be received by WisDOT two weeks prior to the date of the event. Applications received later than
that are subject to denial.


Questions or                  Jake Miller (608) 264-7335
problems?                     jacob1.miller@dot.wi.gov

Submit completed application forms via:
       E-mail (preferred)               FAX                                                           U.S. Mail
                                               (608) 266-0658
      jacob1.miller@dot.wi.gov                                             RTAP Coordinator
                                                                           Bureau of Transit, Local Roads, Railroads & Harbors
                                               If you FAX your
                                                                           Wisconsin Department of Transportation
                                               application
                                                                           PO Box 7913
                                               materials, do not
                                                                           Madison, WI 53707-7913
                                               mail a copy.


Agency/Organization                                                     Official/Officer


Attendee Name (First and Last)               Attendee Position Title          Attendee E-mail Address


Mailing Address (Street or PO Box, City, ZIP Code)                                         Attendee Area Code - Telephone Number


Name of Event                                Event Date(s)                    Event Location (City, State)


What responsibilities does your agency/organization have for providing passenger transportation in the small urban and rural areas?



Reason for program attendance and scholarship request



Submitted By                                 Authorized By                                                      Date
                                               Estimated Expenses
Attendee Name (First & Last)           Name of Event                               Event Dates


Allowable rates for RTAP scholarships are the same as State rates and are subject to change without notice
when the State rates are adjusted. The 2007-2009 Pocket Travel Guide lists current rates for all travel expenses
except out-of-state daily hotel rates, which vary from city to city. (http://oser.state.wi.us/docview.asp?docid=6800)
Contact the RTAP Coordinator for current hotel rate allowances for specific out-of-state cities.


Expense Category                                                                        Estimated Total Expenses
1. Registration Fee/Tuition
   Lodging
        In-State
             $70 per night or special conference rate                                    nights          per night
2.           $80 per night in Milwaukee, Racine and Waukesha counties
        Out-of-State
             Contact RTAP Coordinator for rate
   Is this a special conference or training program rate?                                  Yes          No
   Travel Costs                        In-state        miles          $0.485 per mile
        Out-of-State
             The lessor of airfare plusAirfare expense
             ground transportation Ground transportation fees
                                             Total
             OR
3.
             mileage                   Out-of-state          miles         $0.485 per mile
                                       Enter the lessor of airfare plus ground transportation or mileage

         Other Travel Costs       Parking                         days             daily rate
                                  Other (please specify)
   Meals                                               In-State                Out-of-State
      (Specify Number of Meals) Breakfast                      $8                        $10
4.
                                  Lunch                        $9                        $10
                                  Dinner                     $17                         $20
5. Total Estimated Expenses
   RTAP Scholarship Percentage and Amount
      Enter percentage with a decimal point - e.g. enter 80% as 0.8, 100% as 100.0
           In-state Percentages:

                   WRAPP Roadeo, WRAPP/WURTA Fall Conference,
6.
                   WisDOT-sponsored Mobility Manager Workshops and In-
                   State events totaling $100 or less - 100%
                   All other In-state events - 80%

            Out-of-state Percentage:
7.              All events - 70%
     Scholarship Value

				
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