Date:
Employee's Name:
Job Title:
Funding (Fund/Org):
Travel from (city): to (city/state):
Purpose of Trip:
Explain:
Date:
Date:
Date:
Appropriate Cabinet Member
Date:
VC of Finance & Administration
Date:
Chancellor
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Louisiana Delta Community College
Travel Authorization Form
Rev 09/11/15
Out‐of‐State In‐StateOut‐of‐District InDistrict
obtain approval for all out-of-state and all in-state-out-of-district travel or in-district if seeking reimbursement for mileage
Estimated Expenses:
Employee must obtain approval for out-of-state
travel at least one month prior to the planned trip.
Employee is to maintain the original Travel
Authorization form and attach it to the Travel
Expense Reimbursement Voucher.
I hereby certify that this travel will be performed in accordance with regulations set forth by the Louisiana Division of Adminstration and the
policies of the Louisiana Delta Community College, and have informed myself of these policies and regulations.
Approved:
Approved:
Approved:
Approved:
*Justify below if requesting lodging reimbursement up to 50% in excess of maximum allowed.
Actual cost of conference lodging, for single occupancy standard room, is reimbursable when
staying at the designated conference hotel.
Employee's Signature
Airfare
Lodging*
Meals
Vehicle Rental or Cab Fare
Grant/Contract/Project Name (If Applicable)
Departure Date:
Departure Time:
Return Date:
Return Time:
Registration
Other Allowable Expenses
Supervisor
Total Estimated Expenses
