PROFESSIONAL MEETING REQUEST
DATE: _________________________________________________ NAME: __________________________________________________________
TITLE OF MEETING/CONFERENCE: ___________________________________________________________________________________
(Attach a copy of the meeting/conference announcement)
ORGANIZATION SPONSORING EVENT:________________________________________________________________________________
REASON FOR ATTENDING: _____________________________________________________________________________________________
LOCATION OF MEETING/CONFERENCE:______________________________________________________________________________
MEETING IS (Check one): [ ] LOCAL [ ] STATE [ ] OTHER
DATE(S) OF MEETING/CONFERENCE: FROM ____________________________ THROUGH ____________________________
ARE CLASS DAYS INVOLVED? (If yes, state how you intend to cover for the missed class time.) [ ] YES [ ] NO
_____________________________________________________________________________________________________________________________
ESIMATED EXPENSES ACTUAL EXPENSES
(To be complete by Administration)
REGISTRATION $________________________ $________________________
LODGING $________________________ $________________________
TRANSPORTATION $________________________ $________________________
(If transportation is by private automobile, multiply round trip mileage by .58. This should not exceed the lowest airfare available. If using
the college vehicle, the department will be charged for the mileage cost and this should be included.)
OTHER___________________ $________________________ $________________________
(Specify)
OTHER___________________ $________________________ $________________________
OTHER___________________ $________________________ $________________________
(Use additional space if needed)
TOTAL $________________________ $________________________
(If you need to have registration fees paid directly by the College, identify this requirement.)
________________________________________________ _________________________________________________________
ACCOUNT NUMBER TO BE CHARGED SIGNATURE - DATE
________________________________________________ _________________________________________________________
DEPARTMENT HEAD - DATE VICE PRESIDENT, ACADEMIC AFFAIRS - DATE
Expenses will be reimbursed to a maximum amount of $________________
After return from the meeting complete the Travel Reimbursement Form and attach copies of all receipts to the
form.
REVISED 6/18
**Please contact the SSCC webmaster at webmaster@sscc.edu for suggested updates to this form**
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