Meal Per Diem Form
Event Name & Date _________________________
Hotel Name _________________________
Day & Time Leaving _________________________
Day & Time Returning _________________________
to Liberal (entering city limits)
Days Out of Town _________________________
# of breakfasts provided
by event or hotel _________________________
# of lunches provided by event _________________________
# of dinners provided by event _________________________
Total meals requested Per Diem Amount Total
In State Out of State
Breakfast ___________ $9.00 $10.00 ________
Lunch ___________ $10.00 $10.00 ________
Dinner ___________ $19.00 $25.00 ________
Total Meal Per Diem ________
If the conference, event or hotel provides a meal, no per diem shall be allowed for the meal provided.
No alcohol to be purchased with district per diem.
Due to location of the event, if the total meal expenditures for the entire trip exceed the per diem
provided, the employee can submit all receipts for proof of actual cost and request additional
reimbursement for costs exceeding the per diem allowance if approved by the Superintendent.
Per BOE Policy GAN-R