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RTAP Scholarship Application

This form is also available as a PDF. Email completed PDF forms to jacklyn@calact.org

Online Application

Address (To submit payment)(Required)
Location
MM slash DD slash YYYY

Eligibility Questions

I receive the following funding sources:
The population in my county is:
Organization Type
Provide a brief description of your service area and services provided
Please provide a short description of the training program you are attending, and why it was selected compared to other training programs

Estimated Expenses

Location (County) of Hotel
Used to calculate per diem rates, as per state guidelines
Must be purchased 14 days in advance. Maximum reimbursement for tickets purchased less than 14-days in advance will be based on mileage at a rate that is the same as the automobile mileage reimbursement.
Tolls, Parking, Taxi, Public Transit
Not reimbursed, but can count toward the match requirement (see below). State per diem rates: $50/day, up to a max of $300
Please enter a number less than or equal to 300.
Not reimbursed, but can count toward the match requirement (see below). State per diem rates: $6 per breakfast, $10 per lunch, and $18 per dinner
Hidden
Default 2021 IRS mileage reimbursement rate
Hidden
Hidden

You may be required to justify travel mode based on factors such as mileage or airfare cost and lodging nights required. Maximum reimbursement for tickets purchased less than 14-days in advance will be based on mileage at a rate that is the same as the automobile mileage reimbursement. Please attach a Mapquest sheet with mileage from work place to training site.

Caltrans has provided additional RTAP scholarship funds for the contract which require a minimum of a twenty percent match. The match must be paid by the agency requesting a scholarship. The cost of meals and rental cars at the state rate are not reimbursable from the scholarship fund but can be used toward the match requirement.

Consent(Required)
Certification(Required)
This field is for validation purposes and should be left unchanged.