Total Cost of Stay: ______________________________________ (PTO) Payment to be made in advance by card, cash or cheque. Non-cancellations will be charged. Payment Action Method Cash/Cheque/card payment date: Amount: ………………. ……………. Cash Cash/cheque/card payment date: Amount: ……………… ……….…….. Cheque Card Cash/cheque/card payment date: Amount: ……………… ……………… Invoice Payroll Cash/cheque/card Payment date: Amount: ……………… ……………… (Please Date Invoiced: ……………………………. circle) Date Sent to Payroll: …………………….
Total Cost of Stay: ______________________________________ (PTO) Payment to be made in advance by card, cash or cheque. Non-cancellations will be charged. Payment Method Cash Cheque Card Invoice Payroll (Please circle) Action Cash/Cheque/card payment date: ………………. Amount: ……………. Cash/cheque/card payment date: ……………… Amount: ……….…….. Cash/cheque/card payment date: ……………… Amount: ……………… Cash/cheque/card Payment date: ……………… Amount: ……………… Date Invoiced: ……………………………. Date Sent to Payroll: …………………….
2016NLGHnhsAccommodationRequestForm&ReturnAddress.docx