Travel Request Form - Pk Yonge
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Travel Request Form
Please subm it Travel Request and Application for Leave 3 weeks in advance to
Dawn Szym anski
dszym anski@pky.ufl.edu
352.392.1554 x288
Name _________________________________________________ Date _________________
Departure Date ________ Time ________(Est.) Return Date ________ Time ________ (Est.)
Destination (City)_________________________ (State)________ (Country) _______________
Others Attending_______________________________________________________________
(If more than 3 people, please submit a letter of justification)
Trip’s Primary Purpose
____ To attend _________________________________________________________________
____ To present at _____________________________________________________________
____ To _________________________________________________________________(other)
Justification or Benefit to State
____ Information will be acquired to improve my performance as an educator
____ Information will be disseminated about the lab school’s promising practices
____ Objectives, specified in a grant and approved by the Florida DOE, will be met
____The visibility of the lab school will be extended
____ Other____________________________________________________________________
Transportation Request ____ Yes ____ No
(Required for advance purchase of airline tickets, car rental)
Reimbursement Requested For:
Mileage for _______miles @ 44.5 per mile = _____________
Registration =_____________
Meals for ________days = ______________
Tolls = ___________________
Lodging for _______nights @ ________/night = ___________
Taxi =____________________
Plane Ticket =_____________
Auto Rental = _____________
For Reimbursement: You will need to provide all receipts, including registration, boarding
passes, rental car, bus, taxi, limousine, tolls, gas, and lodging along with a copy of the
conference’s agenda. All items must be turned in, even if they were paid in advance.
Funding Source: ______________________ Approval: _____________________________
1080 SW 11th Street Gainesville, FL 32601
P: 352.392.1554
F: 352.392.9559
pkyonge.ufl.edu
1080 SW 11th Street Gainesville, FL 32601
P: 352.392.1554
F: 352.392.9559
pkyonge.ufl.edu
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