Graduate Programs Honorarium Authorization Form

Name of honoree: *

Honorarium offered for:

For MAAPS Competency Assessment Payment, enter Competency Number:

Date of Completion: *

The honoree is:

I have told honoree to complete W-9.

Non-DePaul Employee Payee Mailing Address (Leave blank if DePaul employee):

Honoree Email Address: *

Student Name: *

Student DePaul ID Number:

Student Graduate Program:

Faculty Mentor Authorizing Honorarium: *

Faculty Mentor Email:

Please upload copy of honoree resume below.