HomeMy WebLinkAboutOut of State Travel Request - New Hope DV/SAG M N 1 COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the 13oard by 12:000m 0M Thursday)
REQUESTING : DEPARTMENT:New Hope
DATE- 2/26/2024
REQUEST SUBMITTED BY:S-uzi Fode
PHONE:764-8402
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OUT OF STATE TRAVEL REQUEST APPLICATION
naveler's Nance*
Trisha Glenn
Departure Date*
E6/2:/A2' 024 --
.11
E-07.:00 AM
Destination (City, County, State)*
Dept/Committee*
..........
New Hope
- ----- 41
Return Date*
['-NOWMENNAMM /6.2024 1
11:30 PM
Washington DC
Ile
................. j
Hotel - GSA Rate*
Hotel - Nightly Rate*
- - --------- ---- - - ........
258 258
Date of Request* Travel Type
2/26/2024 Out of State Travel V
E/ - I
Grant* Fund/Dept*
Yes 128
--------------- ----
Purpose of "ftave*l*
Wow
National Childrens Alliance Leadership
Cost Application* Rental Car Required
Government Rate V Yes so
Hotel Total* C04ference Fee* 7
Daily MME at Destination* Rental Car Cost per day*
1032 700 79 0
40
Explanation for Rate (required if hotel cost is greater than per diem, or gov
177 " " M." -- ---. L � - -- ----- -- ernment rate)*
Air Carrier*
Alaska Air788
Preparer's Name*
Elisa Adolphsen
Preapproved by E0/D11?*
Yes
V
Cost of Flight*
lei
Total trip cost (Include all cost totals)*
--------- --
2127
--- -------
Preparees Title*
CAC Coordinator
Use of travel card to fill a rental vehicle gas tank prior to its
return Is recommended.
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name* Dept/Cominittee* Date of Request*
----------------- -
Elisa Adolphsen New Hope E2/2:6/2024
Departure Date* Return Date*
6/2!2024 E
ro/6/20E
E]
61
0 7:.:-0 0 A M 11:30 PM
EON.,
Destination (City, County, State)*
Washington DC
0 MOW M44 0 4
---j
Hotel - GSA Rate*
Hotel - Nightly Rate*
258 258
Hotel Total*
1032
Conference Foe*
700
Grant*
Yes
Purpose of Travel*
Travel Vype*
Out of State Travel
Fund/Dept*
r28
tj
National Childrens Alliance Leadership
CostApplication*
Government Rate V
Rental Car Required
Yes
Daily MME at Destination* Rental Car Cost per day*
79 0
lie
E xplanation for Rate (required if hotel cost is greater than per diem, or government rate)*
Air Carrier*
Alaska AIr
Preparer's Name*
Elisa Adolphsen
'reapproved by E O/DH?*
Yes
Y
Cost of Flight*
700
Total trip cost (Include all cost totals)*
2127
Preparees Title
CAC Coordinator
..........
Use of travel card to fill a rental vehicle gas tank prior to its
return is recommended,
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name*
Suz!Fode 7M]
Departure Date*
E6/2 /2024
------------
E7:00 AM
'I'll
Destination (City, County, State)*
Washington DC
Hotel - GSA Rate*
Dept/Comm*ttee*
New Hope
Return Date*
616/2024
11:30 PM
Hotel - Nightly Rate*
-258 258
1? ------- - - - - - -
Date of Request*
2/26/2424
Grant*
Yes
Purpose of 1rave1*
'11-avel Type*
OUt of State Travel V
Djawa
Fund/t*
. UP
1 ---- 2 - 8 - ------- - ------
- ------------
National Children$ Alliance Leadership
--------- ---- Ile
Cost Application* Rental Car Required
Government Rate Y Yes V
Hotel Total* Conference Fee*
- - ---------- Daily MME at Destination* Rental Car Cost per day*
F1 1 0
1032 700 79
elm*
Explanation for Rate (required if hotel cost is greater thanper diem, or government rate)*
Air Carrier* Cost of Flight*
Total trip cost (Include all cost totals)*
Alaska Air 70g,.
2'I 27 ------- ------
41 1 ---
Pr
eparees Name*
Pie parees Title*
Elisa Adolphsen
CAC Coordinator
L ld L
Preapproved by EO/DH?*
use OT travel card to fill a rental vehicle gas tank prior to its
Yes return is recommended. a