Diversity & Community Studies Travel Request
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1Diversity & Community Studies Travel Request
Use this request form for one trip only.
Amount Requested from DCS:
(We may use this for “brag points”.)
Attach relevant proof of participation to this form.
_________________________
1)
After obtaining the endorsement of your program director (if relevant), submit this
Amount from other sources:
form to Dr. Olmsted.
_________________________
2)
If you are requesting funds from University College, you also need to fill out their
form found at
3)
At least two weeks prior to the trip, submit the Travel Authorization Form to Dr.
Olmsted. The link for this is https://asaweb.wku.edu/php/prod/wkuforms/source/WKUFormsCreateInst.php?form=TravelAuth.
4)
Upon your return, submit original receipts, departure & return times, and any meals not claimed in per diem, to Renee Purdy.
Date submitted: ____________________
Name:
Program: _________________________________
Destination:
Date(s):
Purpose of Travel (e.g., conference name) (do not abbreviate):
Please describe your professional activities and/or function(s) at the conference or meeting for which you
are requesting funding.
Itemization of Expenses
# of
Rate
Total
Per Diem:
days
Airfare
Breakfast
$9
$10
$11
$12
$13
$14
6:30-9:00 am
Car Rental
Lunch
$14
$15
$17
$18
$20
$21
11:00-2:00
Lodging
Dinner
$23
$26
$28
$31
$33
$36
5:00-9:00 pm
Per Diem
Total
$46
$51
$56
$61
$66
$71
See Chart
Time for meals include travel at listed time or before
Registration
and ends at listed time or after.
Miscellaneous
To find which rate your destination falls under,
please visit the following links.
Mileage is 48¢ per mile.
Round Trip Miles at 48¢ = ____miles x .48 = $_____
Number of Breakfasts: ____ at $_____ = $_____
Number of Lunches: ____ at $_____ = $_____
Number of Dinners:
____ at $_____ = $_____
Total Travel Cost: $
TOTAL PER DIEM = $
Signature: _______________________________
Program Director Signature (if applicable): ______________________________
Updated 9/28/2012
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