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Where would you like your reimbursement check sent?
Please include a copy of your ride receipt. The receipt must include information such as date, time, origin, destination, service provider and cost. Reimbursement requests (including receipt) must be submitted within 10 days of GRH trip date.
 
By submitting this form, you certify that all the information stated above is true. The GRH program has the right to request additional documentation or information, if needed. If the program administrator determines the use of GRH was invalid, no reimbursement will be issued. You are eligible to take a trip three days after registration.
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