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   Grinnell College
Department/Concentration Speakers Fund

Request Form

Please complete the information below:

Name:

E-mail address: (must have complete e-mail address)

Department:

Chair:

Speaking date:

Name of lecturer:

Funding Request
Travel amount:
Honorarium:
Dining:
Other:

Total Request (up to $600):

Travel by personal vehicle is reimbursed at the rate of $.585 per mile.

If you would like a copy of this form sent to you please check the box below:


    

PLEASE NOTE:

You will be notified by e-mail of approval/disapproval.

Thank You!


Revised July 2008

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