We Kan Drive Reimbursement

wekandrive@dccca.org

(785) 764-6674

Please use this form to submit a reimbursement request for expenses related to the We Kan Drive program. Expenses can include items such as licensing fees, Driver’s Education enrollment, insurance policies, and more.

Upon approval a check will be sent to your mailing address.

We Kan Drive - Reimbursement Form

Name(Required)

First Name Last Name

Email Address(Required)

What are the expenses for?(Required)

Total Cost(Required)

Example: $25.00

Who is receiving the reimbursement?(Required)

Address(Required)

Street Address City State ZIP Code

File Upload(Required)

Please upload receipts or invoices here.

Drop files here or

Max. file size: 2 GB.

Youth/Young Adult Participant(Required)

First Name Last Name

Additional Comments/Questions

Please add any additional comments about the reimbursement here.