Florida State Rural Development Council (FSRDC)

2002 Rural VISTA Team Member Training - January 30, 2002

8:45AM 9:45AM
State Library of Florida Auditorium
500 S. Bronough Street
Tallahassee, Florida 32399VISTA TRAVEL FORM FOR FSRDC Team Member Training

(Please fax ASAP to Catherine Hanks at (850) 875-7197; this is the information we will need to authorize travel reimbursement for VISTA Team Member Training Event-failure to submit will mean we can not reimburse you no exceptions)

Full Name

Social Security No.

Mode of Travel:
1) Driving Train* Bus*

*For travel by train or bus, you must purchase your own ticket and request reimbursement when you turn in your travel voucher after the training event.

2) Room Accommodations* (VISTAs will be assigned 2 per room) FSRDC team member who will be traveling MORE than three (3) hours one way may request reimbursement for hotel expenses. You must pay for your own hotel and request reimbursement when you turn in your travel voucher.

Smoking Non-smoking
Male Female

Special Needs (Diet or Accessibility):

VISTA home address and telephone number :


VERY IMPORTANT!!! Please list name of project, address and telephone numbers
where VISTA is working. This form will be returned to you if any of this information is missing.

Name of Project :_
Name of VISTA Supervisor:
Address:
Telephone No. ( ) Fax No. ( )

FSRDC operates a rural Americorps*VISTA team. Team members receive a stipend and an educational award while providing community assistance through their efforts with community organizations. 2001 team sites include:

American Red Cross - Suwannee Valley, Lake City, Florida

American Red Cross - St. Johns River Area, St. Augustine, Florida

Calhoun County Public Library, Blountstown, Florida

Calhoun County Health Department Panhandle Area Health Network, Blountstown, Florida

Empowerment Alliance of SW Florida, Immokalee, Florida

Family Service Network of NW Volusia County, Deland, Florida

Farm Worker Association of Florida, Apopka, Florida

Florida Coalition Against Domestic Violence, Tallahassee, Florida (statewide)

Florida Impact, Tallahassee, Florida (statewide)

Florida Organic Growers Neighborhood Nutrition Network, Gainesville, Florida

Florida State Rural Development Council, Tallahassee, Florida (statewide)

Gilchrist Gleaners, Inc. with the Florida Organic Growers, Trenton, Florida

Gulf County Chamber of Commerce, Port St. Joe, Florida

Heartland Cultural Alliance - Highlands County, Sebring, Florida

Holmes County Development Commission and Chamber of Commerce, Bonifay, Florida

Holmes County Health Department Panhandle Area Health Network, Marianna, Florida

Jackson County Health Department Panhandle Area Health Network, Alford, Florida

Main Street Marianna, Marianna, Florida

Panhandle Pioneer Settlement, Blountstown, Florida

Tourism Development Council - Washington County, Chipley, Florida

Washington County Chamber of Commerce / Community Redevelopment Agency (CRA) Chipley & Vernon, Florida