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Remote Assistance
School Nutrition S.T.A.R. Program – Consultant Orientation – November 28-29, 2018
Institute of Child Nutrition
2018-09-13T10:29:44-05:00
School Nutrition S.T.A.R. Program – Consultant Orientation – November 28-29, 2018
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Account Number
Name
*
First
Last
Email
*
Please enter the best email address to contact you.
Cell Phone
*
Travel Information
Please fill out the following information regarding travel.
W-9 Address (Home Address)
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
NOTE: This address must match the address that you have on file with The University of Mississippi's Procurement office. (You sent this in with the RFP 607.)
Transportation
Please select how you will be traveling to the Consultant Orientation.
Travel Selection
*
I will drive less than 500 miles
round trip
to the training. I have used Rand McNally to estimate my mileage.
Total mileage must be less than 500 miles
.
I will drive more than 500 miles round trip to the training. I have used Rand McNally to estimate my mileage.
I will purchase my own airline ticket and request reimbursement.
I would like ICN to purchase my airline ticket.
Driving Information
Please complete this section if you will be driving to ICN for the consultant orientation.
Note: Please use
RandMcNally.com
to estimate your driving miles. If your mileage is more than 500 miles round trip, you must fill out the Flight Information Section so that we can do a driving vs. flying comparison.
I expect my total driving miles to be:
Note:
A driving vs. flying cost comparison must be approved for round trips greater than 500 miles. Please contact your project coordinator prior to traveling.
Flight Information
Please complete this section if ICN will be purchasing your plane ticket or if your driving mileage round-trip will be over 500 miles.
Note:
ICN has specific policies for purchasing your own airline ticket.
DO NOT
purchase your ticket without a contract. Please contact your project coordinator prior to traveling.
Full Name
First
Middle
Last
Full name as it appears on ID card used for airport security
Departure Airport
Please put your preferred airport that you will depart from. You will fly into Memphis, Tennessee.
Date of Birth
Month
Day
Year
Gender
Female
Male
Rental Car
I will rent a car.
ICN has specific policies regarding payment of rental vehicles. Please contact your project coordinator prior to traveling.
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