Fillable Payment Form Class I

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Payment Form Class I

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ORAL ROBERTS UNIVERSITY
FOREIGN TRAVEL INSURANCE FORM
Please complete this form for any ORU sponsored or sanctioned group traveling outside the United States.
1. All individuals traveling must be listed (unless exempt under the Foreign Travel Policy).
2. Completed list must be turned into Risk Management prior to trip.
3. Monies are to be collected by the department sponsoring the trip for all individuals. Insurance is
mandatory.
4. For insurance credit, submit monies collected with this completed form to Student Accounts on a vault
ticket coded to Fund 110000, Orgn 37200, Program 60, Chart 1. Vault Ticket No.
Sponsoring Department: Destination:
Departure Date: Return Date: Mode of Travel:
Class One (Students, employees, consultants or advisors and volunteers and their respective spouses)
Number of Days: X per day = Cost per individual
INDIVIDUALS ON TRIP = $ TOTAL COLLECTED
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Payment Form Class I

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Completed 28 February 2020

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