APPLICATION TO THE BOARD OF COUNTY COMMISSIONERS OF MEDINA COUNTY, OHIO
FOR APPROPRIATION TO ATTEND MEETING, CONFERENCE, SEMINAR
Date: ____________________
Fund Number(s)
Amount:
Fund Number(s)
Amount:
Fund Number(s)
Amount:
The undersigned respectfully makes application for a total appropriation of $ __________________
Dollars,
The probable cost to said County of the actual and necessary expenses in attendance at the:
(name of meeting/conference/seminar)_________________________________________
located at_______________________________________________
on the date(s) of ______________________________________________
The attendance of the undersigned at the aforesaid meeting/conference/seminar is necessary for the
following reason:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
The following employee(s) are authorized to attend the above stated meeting:
_________________________________ ___________________________________
_________________________________ ___________________________________
If applicable, _______________________ has been designated as an alternate by the elected official or
department head and is authorized to attend out of state training on behalf of the elected official.
Requirement or need for travel must be documented and attached to this application.
COMMISSIONERS APPROVAL
Respectfully submitted,
Resolution No:
___________________________
Date:
Department Head Signature
Journal: Page:
___________________________
Typed Name and Title of Department Head
Revised 09-2007
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome