BTA Form #________________
Blanket Travel Authorization
SECTION 1: TO ESTABLISH A BLANKET TRAVEL AUTHORITY
NAME: ___________________________________ DEPARTMENT: ______________________________
PURPOSE: ___________________________________________________________________________________
BEGINNING DATE ________________________ ENDING DATE ________________________
ITINERARY FOR SCHEDULED TRIPS
Valid for one term only--Fall (Sept-Dec), Winter (Jan-Mar), Spring (Mar-June), Summer (June-Sept)
Date From To Date From To
For information on insurance and liablity issues, contact Department of Risk Management, 426-3610
_________________________________________
(EMPLOYEE SIGNATURE)
(DATE)
Approval: I certify that these trips are necessary and that required funds are allotted for these expenditures.
___________________________________________ ___________________________________________
(DEPT. HEAD APPROVAL) (DATE) (DEAN APPROVAL) (DATE)
SECTION 2: TRIP COST WORKSHEET (optional)
ANTICIPATED TRIP COSTS
Department ID
Mileage ________ miles x $0.455/mile: $ ______________
Meals $ ______________
Lodging $ ______________
Other $ ______________
Total $ ______________
09/09