Form Center

2. This section is to be filled our by the employee. Itinerary must be attached.
4. Employee Name
6. Training Class
8. Date of Training
   Date of Training
10. Location of Training
12. Employee Signature

    1. Yes

    By checking yes, I am providing what amounts to an online signature for this form.
14. Immediate Supervisor Approval
18. Training Fee
19. Pay By

    1. Check
    2. Credit Card
21. Per Diem in State
23. Breakfast
    Number of Meals Times $10
24. Lunch
    Number of Meals Times $14
25. Dinner
    Number of Meals Times $18
27. Per Diem Out of State
29. Breakfast
    Number of Meals Times $10
30. Lunch
    Number of Meals Times $14
31. Dinner
    Number of Meals Times $22
33. Total Amount of Per Diem Requested
37. Mileage Claimed

    1. Yes
38. Mileage Cost
    Number of Miles Times $0.58
40. Other Reimbursements
42. Total Reimbursements
46. Department Head Approval
48. Please note that a one week notice is required for Per Diem. The form needs to be filled out and approved by your Supervisor/Department head before any arrangements or checks will be issued. Please allow appropriate time. All arrangements for per diem, travel, training, etc. will be made by your Supervisor.
    
    If any changes are made to the request after submitted to accounts payable you will be required to foot the bill and then submit receipts later. Please keep in mind that reimbursements will be paid in a timely manner and no requests will be expedited.
52. Document Upload
    Training Itinerary Must Be Attached to This Form
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field