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STAFF OUTING FUNDS REQUEST
Superior Human Services, Inc. Staff Outing Funds Request Form
Group Home Location:
*
Date of Request:
*
Amount of Funds Being Requested:
*
How much is the outing going to cost for the staff to go. Make sure that if a client has two staff that you request enough for both staff.
Which Individuals will be attending the outing:
*
Please make sure to name all individuals that will be going on the outing.
Date of outing:
This should be the date that the outing is going to occur.
Intended Use For This Money:
*
Please explain what outing this money will be for or any other uses the money may be used for.
Staff Making The Request:
*
Who is making this request?
Staff Receiving Funds: Not to be filled out until funds are picked up at the office.
Amount of funds given:
This is to be filled out by office personal.
Cash or Check:
This is to be filled out by office personal.
Check #:
This is to be filled out by office personal.
Staff signing for funds:
To be signed by the staff that picks the funds up from the office.
Verification
Please enter any two digits
*
Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:
