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Instructions: Please be sure to receive confirmation that the event is eligible for stipend prior to event and check with the lead of the event for stipend rate and transportation and childcare pre‐approval.

•  Mileage is paid at the federal rate for the most direct route to and from the meeting.

•  Childcare must be pre‐approved by staff and will only be paid for the duration of meeting and time spent driving from the meeting to/from childcare location.

Submit completed forms to the event lead or to Lincoln Arneal, Director of Youth and Family Engagement, at larneal@nebraskachildren.org.

Contact Information

*If you have previously received a stipend or payment from Nebraska Children, do NOT include your SSN.
If you have not previously received a stipend or payment from Nebraska Children, please include your full SSN. To keep your SSN safe,
please notify Lincoln Arneal or your event lead once you have submitted your stipend form. This process will ensure your SSN remains protected.

Additional Details

You may choose to receive paper checks via mail, however this may result in a delayed payment.

Transportation

$0.575 per mile (complete only if you drove your own car to this event):

Miles (round trip) X $0.575 =
Childcare

$5 per hour per child ‐ complete only if you paid someone to watch your child(ren).
(Maximum amount allowed is $50 per day/event and must be pre-approved by event lead)

Hours of childcare provided x $5 x Number of children = TOTAL
Stipend Amount + Transportation Amount + Childcare Amount = TOTAL
Which NCFF staff member asked you to fill out the stipend form?
Confirmation
(you may choose to receive paper checks via mail, however this may result in a delayed payment)