Request For Honorarium Payment - Nipissing University Page 3
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3Conflict of interest or engagements with related parties must be disclosed in advance to the Dean or Director.
Honorarium Payment Procedure:
In order to process a Honorarium payment, the following “Request for Honorarium Payment” form must be
completed and signed by all parties. Please be prepared to provide the following information:
Name of honoree/speaker/individual
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The mailing address for the cheque, if necessary
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Honoree’s institution or organization
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Purpose of honorarium
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Date of engagement (dd/mm/year)
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Time or effort being recognized
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Amount offered (include travel allowances, expected reimbursements, if applicable, on a separate line)
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Signatures of sponsoring faculty/staff member and their supervisor/dean
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Cost Centre to be charged
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Effective Date: July 1, 2009
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