Nevada Rural Hospital Partners Foundation

Nursing Apprentice Program ARPA Grant 

Nurse Apprentice Travel Request

Hello , please validate your personal information:

You have made a request for travel reimbursement for your travel to support your nursing apprentice work at from at to at . 

Summary of your request:

Travel started at on , arriving at the facility at . Mileage reimbursement of miles was requested as were outbound travel day meals totaling .

Additional meals for non-travel days in the amount of were requested for:

• meals in the amount of
• meals in the amount of
• meals in the amount of
• meals in the amount of

NO lodging was requested during this travel period.

Your return trip departed the facility at on arriving home and ending travel at . Mileage reimbursement of miles was requested as were return travel day meals totaling .

     
     
      $0
      

By signing this agreement, you declare under penalties of perjury that to the best of your knowledge this request is true and correct in conformance with governing statues and the requirements of this Nursing Apprentice Program ARPA Grant.