California Forensic Medical Training Center Scholarship

If requesting a scholarship to attend a CCFMTC conference or training, please complete this form and return it with the required receipts (if applicable). When requesting a scholarship for travel/airfare, CCFMTC will cover your travel expenses based on the least expensive and more direct route (per the State Board of Control). CCFMTC must receive this form within 30 days of the date of the event or you will not be reimbursed for your expenses.

Training/Conference  *Training/Conference Date  *Date/Time of Departure  *Date/Time of Return  *Lodging: Unless otherwise authorized, CCFMTC MAY pay for one night’s lodging (only when necessary) for each day of presentation at the seminar site, not to exceed the state-government per diem rate. Checkout must be on the last day of the training/conference. State-Wide Lodging Rate  *Lodging # of nights  *Lodging Total (Rate x # of Nights) When applicable the hotel receipt must be attached. Total Claim Hotel Receipt Name  *Direct Phone  *Title/Agency  *Address  *City  *State  *Zip  *Email  *By checking this box and submitting this form I certify that the above information is true and correct. 

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