Academic Faculty/Staff Travel Pre-Approval Form
Name:_____________________________________ Date:___________________
Destination:__________________________________________________________
Purpose of Trip:_______________________________________________________
Depart Date: ___________ Return Date_____________ P-Card Last 4 Digits _________ (If applicable)
All expenses, EXCEPT for meals, may be charged to a p-card. Meals and incidentals will be reimbursed using
per diem.
Fund Account: Dean’s Prof Travel:_____ Coss Faculty Dev:_____ BKT Grant:_____ Other:___________
Transportation/Hotel: (please fill in all that apply)
Personal Vehicle (.575/mile): $______________ (Crawfordsville–Indy Airport 100 miles= $57.50)
College Vehicle (.40/Mile): $______________
Flight/Baggage: $______________ Booked through Travel Coordinator? ______
Parking/Ground Transportation $______________
Hotel/Lodging: $______________
Conference Travel:
Registration $______________
How many meals are included in the registration and/or hotel cost?
Breakfast #________ Lunch #________ Dinner #________ All Meals _______
Meals:
Are you requesting reimbursement for meals? _______
*If yes, meals will be reimbursed at the per diem rate of 75% for the first and last day of travel with a max of 5
days total. Receipts are not needed and any meals provided through a conference/meeting will be subtracted
from the per diem reimbursement. www.gsa.gov/travel/plan-book/per-diem-rates
Meal Per Diem: Whole Day: $_______ First/Last Day (75%): $________ Total Per Diem: $________
Total Estimated Expenses: $______________
Traveler’s Signature: _________________________________________________
Dean of the College’s Office Signature of Approval: ____________________________________________
Dean’s Office Notes:
Prof Travel Balance: $______________ FDC Balance: $______________ BKT Balance: $______________
