Verification Memo: International I, _____________, attended the Workshop on Transactional Emotions in Marina del Rey, CA on October 26-28, 2007. The following pages contain the expenses I accrued during that time, as well as copies of both my passport and Visa documentation. I understand that regardless of the value of the receipts presented, I will only be reimbursed up to $1,200 USD as an international participant. I request that the funds be converted to ______________. Please remit payment to the address below: Organization :_______________________________ Street Address :_______________________________ City State Zip Signed Passport # :_______________________________ :________ :________ :___________________ :___________________
Email Address :___________________