Oregon Federation of Square & Round Dance Clubs
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| Date | |
| Lodging Allowance ($40.00) | $ |
| Travel miles - one way ________ @ 60 cents | $ |
|
Other Expenses (please attach sales slips, copies of bills, etc.): |
|
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| Total: | $ |
| Requested by: | |
| Office held: | |
| Area: | |
| Make payable to: | |
| Fund to be charged: | |
| If substitute, please indicate the person you are representing: | |