Certification of Employee Routine Field Travel Name of Employee Date Job Title Fiscal Year (annual certification required) Division/Department Work Domicile (regular campus/site) In accordance with Louisiana Office of State Travel Regulations, I understand that field travel under a 30 mile radius of an employee’s regular work domicile is not reimbursable unless the employee is certified for regular, routine field travel.
I hereby certify that routine field travel is a regular and necessary part of the performance of the above employee’s duties, for the noted fiscal year, as described below: Check one: Practicum/ Clinical Instruction/ Cooperative Education – Employee has regular duties as part of a practicum, clinical instruction, or ...
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Microsoft Office Word (.doc, .dot) - application/msword
1380-003 Certification for Employee Routine Field Travel Form 7-10.doc
DELGADO FORMS 
