DIVISION SPEAKER GUEST VOUCHER

Science Division

Date: ____________________

Name of Guest ____________________________________________________

Purpose of Visit _________________________________________________

__________________________________________________________________

Date(s) of Visit _________________________________________________

Expenses (Attach receipts when available)

   Honorarium _______________________________________  $__________

   Travel ___________________________________________   __________

      (Indicate places traveled to and from with miles)

   Meals ____________________________________________  __________

   Accommodations ___________________________________  __________

   Other Expenses (list)

     ________________________________________________  __________

     ________________________________________________  __________

     ________________________________________________  __________

   Total                                              $__________

Make check payable to ____________________________________________

   Address _______________________________________________________________________

Charge to:  DIVISION SPEAKER-SCIENCES

            #10-108-80902-51421 (travel)

            #10-108-08902-51333 (speakers)

            #10-108-08902-51111 (supplies)

            #10-108-08902-51221 (printing)

            #10-108-08902-51231 (postage)

Approved by: _____________________________________________________

                       Science Division Chairperson

                            Dean of the College