Appendix E. Forms

Membership Application Form

Motion Form

TO RECORD YOUR MOTION ACCURATELY in the minutes of the Board, please restate the motion on this sheet exactly as presented and give it to the Secretary.

Thank You.

MOTION

MOVED that:  _________________________________________________________________________________

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                 By:  ___________________________

Seconded by:  ___________________________

        Session:   ___________________________

            Date:   ___________________________

Request for Reimbursement of Travel Expenses

NORTH CAROLINA LIBRARY ASSOCIATION

    Name:_____________________________________________________________________               Date:   _________________

Address:    __________________________________________________________

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__________________________________________________________

Section, Round Table, Committee, etc.:________________________________________

Destination/Purpose of Trip(s):_______________________________________________

Time and date leaving:_________________ Time and date returning: ______________

Summary of Reimbursable Expenses (State rates for instate/out-of-state)

No of Each          Meal Rate

               Meals:Breakfast(s)      _________   x  $ 6.50/6.50      =    $____________

Lunch(es)           _________   x  $ 8.50/8.50      =    $____________

Dinner(s)            _________   x  $14.50/16.50    =  $____________

Type of Transportation:_________________________________________          $___________

Lodging (attach receipt): $55.50/66.00$___________

Registration (attach receipt):$___________

Mileage:  ___   miles    x   $0.36    =            $____________

Other:(Explain & attach receipts):                                                                                        $___________

  Total Due          $ __________

SUBMITTED FOR PAYMENT: ____________________________________________                   ______________________________

                              Signature of Requestor                                                                           Date

APPROVED FOR PAYMENT:                                                                                                                  ______________________________

                                                                  Signature of Chair or President                                                                Date

(Do not write in this space – For use by Treasurer only)

Check Number:                                               _                            Date:                                   ____________________________

Budget Code:                                                                           Signature of Treasurer:                                                                                                 

rev. 2003-05-20