Fill - Free fillable Texas Woman’s University - Request for Trip Card PDF form

Procurementand Contract Services

P.O.Box425439/BralleyAnnex

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Denton,TX76204 ‐5439

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P: (940)898‐3812

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F: (940) 898 ‐35 Rev: 10/16

RequestforTripCard

Procurementand Contract Services

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TripCardProgram

TRIPINFORMATION

TWUEmployeeresponsibleforCardandReconciliation

PurposeofTrip

TripDestination   DepartureandReturnDates

TRIPCOSTESTIMATE

RegistrationFeeandMe th odofPayment*:____ ____ _ PCard PurchaseOrd er PersonalCheck/Credit/Cash

*Ifforaconference,acopyoftheregistrationform,conferencebrochure,etc.mustbeattached.

EstimatedCostofTransportation: _____

EstimatedLodgingCost:______(CostofRoompernight)X

______(NumberofRooms)X

______(NumberofNights)=

TOTALestimatedlodgingcost$_________

EstimatedIncidentalExpenses(meals notprovidedbyconference,baggagefees,gas,hoteltaxes,etc):$________

TOTALestimatedCost:$__________

Yourdepartmentmaylimitthisamount.

ACCOUNTANDDEPARTMENTALAUTHORIZATION

Departm ent RequestingTripCard DepartmentContactPhoneNumber

DepartmentAccountNumber

Cardholder Signature Date

Dept.HeadAuthorizationSig nature Date

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ModeofTransportation(

checkallthatapply): PersonalVehicle RentalCar UniversityVehicle Other:

0.00

Number of Students Traveling

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Texas Womans University - Request for Trip Card

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