STUDENT MEALS PAID BY MATC DISTRICT CREDIT CARD

STUDENT MEALS PAID BY MADISON COLLEGE DISTRICT CREDIT CARD
CARDHOLDER NAME: _________________________________________________________________________________
DATE/S OF TRIP: ____________________________________________________________________________________
DESTINATION: ______________________________________________________________________________________
PURPOSE OF TRIP:___________________________________________________________________________________
STAFF ATTENDING:______________________________________________________________________________________
STUDENT INFORMATION:
|Printed Student Name |Student Signature |Printed Student Name |Student Signature |
|1. | |16. | |
|2. | |17. | |
|3. | |18. | |
|4. | |19. | |
|5. | |20. | |
|6. | |21. | |
|7. | |22. | |
|8. | |23. | |
|9. | |24. | |
|10. | |25. | |
|11. | |26. | |
|12. | |27. | |
|13. | |28. | |
|14. | |29. | |
|15. | |30. | |
EXPENSE INFORMATION:
VENDOR NAME: __________________________________AMOUNT OF CHARGE: ________________
NUMBER OF ATTENDEES: STAFF________ STUDENTS:_________
VENDOR NAME: __________________________________AMOUNT OF CHARGE: ________________
NUMBER OF ATTENDEES: STAFF________ STUDENTS:_________
VENDOR NAME: __________________________________AMOUNT OF CHARGE: ________________
NUMBER OF ATTENDEES: STAFF________ STUDENTS:_________
___________________________________________________________________________________
VENDOR NAME: __________________________________AMOUNT OF CHARGE: ________________
NUMBER OF ATTENDEES: STAFF________ STUDENTS:_________
VENDOR NAME: __________________________________AMOUNT OF CHARGE: ________________
NUMBER OF ATTENDEES: STAFF________ STUDENTS:_________
I declare, under penalties of perjury, that this account of meal expenses is true, correct and in conformity with the Madison College District travel and District Credit Card policies. These are actual, reasonable and necessary expenses incurred by me personally in the performance of assigned duties. No part of this account has been reimbursed to me.
Cardholder’s Signature:__________________________________________Date:______________________
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