Guest Lecturer/Honorarium & Travel Request

Mercer University School of Medicine

Guest Lecturer/Honorarium
Memorandum of Agreement.

***Please send a completed W9 to Nell Moore or Afrika Bush-Lewis for set up in accounts payable system.
Date*

MonthDayYear
Todays Date
Guest Lecturer Name:*
Title of Lecture:*
School Location:*
Event Location:*
ie. Auditorium, CDAC etc.
Mercer University will compensate a flat fee of $enter amount for the day's or week's services and reasonable travel expenditures for hotel and mileage (the standard rate) please include mapquest (if applicable).
Mileage
Enter total miles driving.
Mileage Reimbursement

Expense Table

Total Cost ($)
Requestors Name:*
Requestors Email:*
example@example.com
Role at Mercer*
Items to be attached include map, agenda, estimated travel costs (air fare, hotel, registration fee).

Cancelof
Should be Empty:

Memorandum of Agreement.