Raven - Family Reimbursement Form

Payment has already been initiated for this request. The information is available for viewing only. If you need assistance or notice an error, please contact Raven staff.

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This request is being completed by {staffFirst} {staffLast} on behalf of the family. Please note that the parent will still receive notifications.

Format: (000) 000-0000.

We couldn’t find a matching family...

Please verify that the family number and phone number match the information listed in Brightways. Families are usually added within a week of the ILP meeting. If you need help, please contact your Raven office:

Anchorage: 907-249-1301

Delta Junction: 907-249-1302

Eagle River: 907-249-1303

Fairbanks: 907-249-1304

Juneau: 907-249-1305

Wasilla: 907-249-1306

Date

Hi {parentfirstname}!

Please submit a separate request for each purchase. Choose a category below, enter the purchase details, and attach your receipt before signing.

Questions about eligible expenses? Read the reimbursement guidelines.

Hi {staffFirst}!

Please complete the following fields on behalf of {parentfirstname} {parentlastname}.

Tutored courses at private institutions will be eligible for reimbursement at the end of the first quarter and parents have completed the progress reports. No tutored courses will be reimbursed prior to October 15th.

The ASAA Alternative Eduction Fee category should only be used if the payment meets the following criteria. The payment was

Paid to a local school district
For participation in a 9th - 12th grade ASAA activity
Charged only to correspondence students from other districts

Note that not all school districts charge correspondence students additional fees for participating in ASAA activities. If the payment included a standard portion and additional fee please submit two reimbursement requests. One for the standard fee using the Activities Category and one for the additional fee using the ASAA Alternative Education Fee category.

This reimbursement will be processed using {Student1FirstName}'s allotment.

Gym memberships costs must be pro-rated according to the number of family members on the gym membership. Raven will pay the share of one parent acting as a chaperone for the students. For example, a couple with three children have a membership that costs $182.00 per month. Assuming all three children received allotment as Raven students, the Amount to be Reimbursed will be $182 / 5 total family members * 4 eligible family members = $145.60. Please exclude upgraded membership fees, locker rentals, late fees, etc from the calculation.

Raven Homeschool will reimburse families for tutored courses according to the rates listed on the Pre-Approval Request for Lessons & Tutoring Services. Please attach the receipt / payment history. Please enter the pre-approved amount in the Reimburseable Amount field.

Raven Homeschool will pay for educational activities for enrolled students that align with their Individual Learning Plan. The costs of one chaperone are also eligible to be reimbursed. For example, a couple with two enrolled children go to the SeaLife Center. Raven Homeschool will reimburse the family for the entrance fee for the two children plus the fee for one of the parents.

Subscriptions purchased after October 15 over $300 must be pro-rated according to the number of months of use between July 1st and June 30th. For example, a $600 subscription purchased in December would be pro-rated as follows: $600 / 12 months * 7 eligible months = $350.00. Families may submit the remaining portion for reimbursement the following year.

Subscriptions purchased after January 15 must be pro-rated according to the number of months of use between July 1st and June 30th. For example, a $180 subscription purchased in February would be pro-rated as follows: $180 / 12 months * 5 eligible months = $75.00. Families may submit the remaining portion for reimbursement the following year.

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