Title of Activity
LIST ALL THE EXPENSES IN THE CATEGORIES LISTED BELOW – PLEASE PRINT LEGIBLY
ORIGINAL RECEIPTS AND APPROPRIATE DOCUMENTATION MUST BE ATTACHED.
Keep copies for your record
I have read the Official District Travel Memo printed on the back side of this form and hereby certify that expenditures claimed are true and
correct, incurred according to the law and City College regulations, and in connection with official business of City College of San Francisco.
________________________________________________ ______________________ ____________________
OFFICE USE ONLY
__________________________________________ $_________________ ___________________
Payment Authorization Signature Refund Amount Date
College Appropriation Number
Official District Travel Memo
All documents must be submitted within TEN (10) business days after the activity ends, or you may not be reimbursed. ORIGINAL paid receipts are
required for business