CLI Course Assistance Expense Form-2

	A	B	C	D
1	Course Assistance Expense Form, Community Learning Initiative, Trinity College, Hartford CT
2	File > Download As, OR login with Google username to File > Make a Copy to save to your Google Drive
3	See steps and allowable types of expenses at:	http://commons.trincoll.edu/cli/course-assistance/
4	Submit forms and receipts to Erica Crowley, 70 Vernon St.	Form updated 2018-08
5
6	Faculty name:
7	Course number and title:
8	Semester taught:
9	Community partner and contact information:
10	Date of submission:
11
12	Reimburse faculty for these expenses:
13	Describe expense (attach receipt & proof-of-payment)	Insert your description here	Amount:	$0.00
14	Describe expense		Amount:	$0.00
15	Describe expense		Amount:	$0.00
16	Where should CLI send the check?
17
18	Mail stipend to community partner:
19	Name:		Amount:	$0.00
20	Home address:
21	Date and description of service:
22	Download and attach completed W-9 form
23
24	Pay for food charged by Chartwells
25	Date and description		Amount:	$0.00
26
27	Pay for printing charged by Central Services
28	Date and description		Amount:	$0.00
29
30	Pay for transportation charged by Trinity Facilities
31	Date and description		Amount:	$0.00
32			TOTAL:	$0.00
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100