NORTHEASTERN OKLAHOMA A&M COLLEGE
TRAVEL REQUEST (In-State and Out-of-State Travel)
APPLICANT__
______________________________POSITION (Title)___________________________________
DEPARTURE DATE ________________________ APPROXIMATE TIME ______ a.m. ______ p.m.
RETURN DATE____________________________APPROXIMATE TIME _______ a.m._______ p.m.
DESTINATION ______________________________________________________________________________
PURPOSE OF TRIP___________________________________________________________________________
____________________________________________________________________________________
(Meeting, Workshop, Convention, Recruitment, etc. (Include a copy of information about the meeting, workshop, or convention if available)
NAMES OF THOSE ACCOMPANYING YOU_____________________________________________________
(Attach a sheet listing names if additional space is necessary)
MODE OF TRAVEL: COLLEGE VEHICLE REQUESTED: Car 12-Passenger Van Minivan
42-passenger Bus Minibus (24-32 passenger) Personal Vehicle
COMMERCIAL (type)_______________________
IT IS VERY IMPORTANT THAT YOU COMPLETE THE FOLLOWING:
Department No.____________ Is money available in current budget? Yes No
ESTIMATED COST $_________________________ $_________________________
Commercial Travel Fare Per Diem - 24-hour period
Yes No Requisition submitted for pre-payment of airline ticket
$_________________________ $_________________________
Registration fees, etc. Lodging
Yes No Requisition submitted for payment of registration fees
$_________________________ $________________________
Other (parking fees, shuttle, etc.) TOTAL
(Travel will not cover more than 24 hours before start of meeting or 24 hours after meeting has ended.)
____________________________________ _____________________________________________
Signed - Requester Date Signed- Dept. Chair or immediate supervisor Date
_________________________________________ _______________________________________________
Signature - Vice President Date APPROVED BY PRESIDENT DATE
(obtain appropriate signature)
Revised: 11/13
(Travel reimbursement rates are attached)
NA NA
NA
NA
NA
NA
REMARKS:
REGULATIONS GOVERNING USE OF COLLEGE AND PERSONAL VEHICLES
Personal Vehicles
State vehicles should be used for all official travel unless specific exceptions are approved in advance by the
appropriate administrator (vice president, president). Requests to use a personal vehicle for official travel
(Request for Use of College Vehicle form) need to be submitted in advance (a minimum of three days) for
review. Such a request must be approved prior to the travel in order for reimbursement to be processed.
The State does not assume coverage for physical damage to an employee's vehicle, only liability coverage is
afforded during performance of work duties.
It is recommended that no one accompany driver; however, if you must take a spouse or others along, make sure
you have adequate personal insurance coverage. They will not be covered by Risk Management. Only
authorized requester/individual should operate the vehicle.
College Vehicles
Requirements:
1. Valid driver's license
2. Driver will use the vehicle only for State or other covered entity business and within the "Scope" of
the driver's employment/authority.
3. Wear his/her safety belt
4. Observe all traffic laws
5. Unauthorized person will not be allowed to drive vehicle
6. Consumption of alcoholic beverages or narcotics prior to the operation of a vehicle is prohibited.
7. Driver will ensure that windows, headlights, and tail lights are clean and operational at all times.
8. Turn signals must be utilized by driver at all times when making a turn or changing lanes.
9. Do not "tail-gate"
10. Where vision is obstructed, do not make turn-abouts, i.e., (u-turn).
11. Vehicles are not to be parked in such a manner as to constitute a traffic hazard to the driving public.
12. Designated speed limits on streets and highways will be observed.
Maintenance Requirements:
Before operating a State or other covered entity vehicle, the driver is responsible for checking to see that all
necessary safety equipment and control devices are in good condition before he/she operates it. These items
should include:
1. Lights 6. Horn
2. Directional Signals 7. Tires
3. Steering Wheel 8. Safety Belts
4. Brakes 9. Windshield Wipers
5. Rear-view and Side-view Mirrors 10. Defroster
For vehicles used to transport people, such as an activity bus or van, the following items, in addition to those
listed above, should be included:
1. Reflectors
2. Fire extinguisher, Type B-C
3. First Aid Kit
NEO A&M COLLEGE
Visit: www.gsa.gov
$89.00 $98.00 $89.00
51.00 59.00 51.00
38.25 44.25 38.25
25.50 29.50 25.50
12.75 14.75 12.75
61.00 69.00 61.00
45.75 51.75 45.75
30.50 34.50 30.50
15.25 17.25 15.25
0.33
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