Academic Affairs Travel Authorization Form

 

ACADEMIC   A FFAIRS   T RAVEL   A UTHORIZATION   F ORM  

 

The   omission   of   filing   a   travel   authorization   form   with   the   university   prior   to   actual   travel   may  

exclude   traveler   from   university   insurance   protection   and   will   also   disqualify   any   expense  

reimbursement   r equest.    

R equests   f or   a pproval   o f   a cademic   t ravel   s hould   b e   r eceived   i n   t he   D ean’s   O

ffice  

and/or   Provost’s   Office   at   least   1-­‐week   prior   to   scheduled   travel   in   order   to   qualify   for   reimbursement   of  

expenses.  

 

Name     _ _________________________________________________________________________  

 

Department     _ _______________________________________________     D ate     _ _______________  

 

Are   s tudents   t raveling   w ith   y ou?     _ ______.     I f   y es,   a ttach   l ist   o f   s tudents   w ho   w ill   b e   t raveling.  

 

Name   o f   O rganization/Meeting     _ ______________________________________________________  

 

Location(s)   a nd   D ate(s)         _ ____________________________________________________________  

 

Purpose   o f   T ravel     _ _________________________________________________________________  

 

_________________________________________________________________________________  

 

Mode   o f   T ravel     _ __________________________________________________________________  

 

 

Estimated   R eimbursable   E xpenses:    

 

Transportation     _ _____________  

 

 

 

 

 

 

 

Hotel     _ _____________________  

 

 

 

 

 

 

 

Meals     _ ____________________  

 

 

 

                         

 

 

Registration     _ _______________  

 

 

 

 

 

 

 

Miscellaneous       _ _____________  

 

 

                         

 

 

 

 

TOTAL     _ ___________________  

 

Approved   f or   $ ________  

Acct   #   _ _______________               _ _______________________________  

 

 

 

 

 

 

 

                              D epartment   C hair  

 

Approved   f or   $   _ _______  

Acct   #   _ _______________  

_________________________________  

 

 

 

 

 

 

 

Dean  

 

Approved   f or   $   _ _______  

Acct   #   _ _______________  

_________________________________  

 

 

 

 

 

 

 

 

Provost   a nd   V PAA   ( if   a pplicable)  

Total   a pproved   f or   r eimbursement:   _ _______________  

 

I   u nderstand   t hat   t rip   e xpenses   m ust   b e   s ubmitted   f or   r eimbursement   t o   t he   d ean’s   o ffice   n o   l ater  

than   f orty   f ive   ( 45)   d ays   a fter   l ast   d ay   o f   t ravel   i n   o rder   t o   b e   r eimbursed.      

 

________________________________________________________________  

Signature   o f   F aculty/Staff  

MAKE   C OPIES   F OR   D EAN,   D EPARTMENT   C HAIR   A ND   F ACULTY   M EMBER   W HEN   C OMPLETED