Cerritos Community College
Associated Students Travel Request Form
Part I: Advisor and Conference Information
Advisor Name: _________________________________________ Extension: ____________________
Department: _____________________________Club: ________________________________________
Name of Conference: ___________________________________________________________________
Location (City and State): _________________________________ Dates: ________________________
Purpose of Conference: _________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Part II: List of Student Travelers
STUDENT NAME (LAST, FIRST)
STUDENT ID
STUDENT NAME (LAST, FIRST)
STUDENT ID
(Please attach additional sheets if needed)
Part III: Estimated Expenses for Entire Group
Registration: _____________ Lodging: _____________ Meals: _________________________
Airfare: _________________ Taxi/Shuttle: _________ Vehicle Rental: __________________
Mileage: ________________ Parking: _____________ Other: _________________________
Describe Other: _______________________________________________________________________
Funding:
ACCOUNT #
AMOUNT
ASCC Allocated
600 - -
$
Fundraised
250 - -
$
TOTAL
$
Part IV: Flight Information
STUDENT’S LEGAL NAME
DATE OF BIRTH
Departure Airport: __________________________ Arrival Airport: _____________________________
Flight Preference print-out attached
Use airline website, not 3
rd
party vendor such as Expedia or Orbitz.
Flights not needed
Part V: Hotel Information
Hotel Name: __________________________________________________________________________
Street Address: ________________________________________________________________________
Check-In Date: _____________________________ Check-Out Date: ____________________________
Nightly Rate: ____________ Total Including Tax and Resort Fees, if applicable: ____________________
Hotel print-out attached
Use hotel website, not 3
rd
party vendor such as Expedia or Orbitz.
Hotel not needed
Part VI: Approval and Authorization
Please attach a copy of the completed and approved (with signatures) Conference and Travel Request
Form for all Cerritos College Staff/Faculty traveling with this activity.
Advisor 1: ______________________________ Signature: _________________________ Date: _______
Advisor 2: ______________________________ Signature: _________________________ Date: _______
Dean of Student Services Signature: ____________________________________ Date: ______________
Revised: July 2017