Corporate Card for Travel
Application
Applicant name: ______________________________________________
Date:_______________________
Department Name: ____________________________________________ Work Phone: (_______)____________________
Dept. GL Acct. Number: _________-________________-___________ Applicant SS#__________________(Last 4 digits)
1.
Default single transaction limit:
$1,500
Ot
her amount requested $____________________
2.
Default monthly credit limit: $1,500
Ot
her amount requested $____________________
Department Head ______________________________________________ Date:_______________________
Print name ____________________________________________________
Dean (if applicable) _____________________________________________ Date:_______________________
Print name_____________________________________________________
Area V.P.______________________________________________________
Date:_______________________
Print name_____________________________________________________
Program Coordinator: __________________________________________
Date:_______________________
Print name____________________________________________________
Approving Individual____________________________________________
Date:_______________________
Print name__________________________________________________
Approving Individual____________________________________________
Date:_______________________
Print name ____________________________________________________
Cardholder_____________________________________________________ Date:_______________________
Program Coordinator ___________________________________________ Date:_______________________
I acknowledge receipt of the Monmouth University Travel Card, the Monmouth University Travel, Entertainment and Food Policy and the
Travel Card Policy and Prodedures document. I confirm that I have read, understand, and will comply with the terms of both of these
related policy and procedure documents. I agree that my use of the Card will be for University business only and that I will be the only user
of the Card. I will return my Card to Human Resources or the Program Coordinator at my termination or upon request. I understand that
the University may terminate my privilege to use this Card at any time and for any reason including misuse of the Card. I further
understand that I must document the expenses charged to my Card within 20 business days after receipt of my monthly statement. If I fail
to do so, I authorize the University, at its option, to deduct the amount of the undocumented or unallowable charge from my pay.
**Reason:
________________________________________________________________________________________________
**Reason:________________________________________________________________________________________________
**A written reason must be provided if higher amount is being requested.
For Controller’s Office Use Only
Works
Co. Prop.
E-mail
Employee ID:______________
*** To Be Signed By Cardholder When Card is Issued ***
