Phone: (360)754-7711 ext. 5217
Fax: (360)596-5708
Email: cuhrich@spscc.ctc.edu
9/2011
South Puget Sound Community College Student Life
Name Signature Date Amount Received
Total Participants Check #
Total Distributed Amount
Returned
Amount of Advance
Advance Release Form
Club /Organization ________________________________
Travel Authorization #_______________