College of Healthcare Sciences
1.
Request for Travel
2.
Request to use DBA / IRA / SSA / Grant funds
3.
Application for additional funding
ORGU:
The College (CHS) Nursing and Midwifery Occupational Therapy
Physiotherapy Psychology Speech Pathology Sport and Exercise Science
Purpose of this form:
To obtain Approval to Travel or being absent from College/JCU on JCU business; and/or
To obtain approval to use DBA/IRA/SSA/Grant or Project funds, for travel or purchase requests; and/or
To obtain further assistance from Discipline/ College to assist with additional funding, over the balance of
the DBA/IRA/SSA/Grant or Project accounts.
Important Process to note:
This form needs to be completed (as applicable) and submitted via email to the respective Academic Head (“cc”
to chs.admin@jcu.edu.au
) and approved PRIOR to any funds being committed.
The CHS Leadership Group will need to complete the form (as applicable) and submit it via email to the Dean (“cc”
to chs.admin@jcu.edu.au
) for discussion and approval PRIOR to any funds being committed.
For ALL Travel purposes - If the request is approved please upload the approved request into CONCUR
For ALL Non-Travel purposes - If the request is approved, please email approval to chs.admin@jcu.edu.au for any
purchasing requirements.
Name:
Email:
Phone:
Emergency contact
(for travel only):
Phone:
REQUEST
What is the purpose of this expenditure?
How does this activity benefit CHS, the Academic Group or JCU?
What deliverables are expected from this activity (include timeframe)?
Supporting documents (eg. Conference registration, Budget, Acceptance, Requests etc)
Attached
Do you have commitments during this period? Yes No
If yes, what arrangements have been made to cover your teaching or administrative responsibilities?
Additional comments (include any income which will be received during the year).
Does this funding include travel?
Yes
No
TRAVEL
Departure Date
Return Date
Destination
Approximate Cost of Travel (include Airfares, Conference Registration, Accommodation, Car Hire, Meals and Ground
Transport):
N.B. Once travel has been approved, corporate credit card holders can register and pay for their conference
registration with their corporate card. Non corporate card holders can contact the Admin Team to arrange 3
rd
party payment.
Attached
Supporting documents (e.g. Travel Approval, Budget)
Your contact details for this period of travel?
Phone Email
Conference Registration
Do you require conference registration?
Is there an early bird registration?
If so, what date is the registration due?
Do you have any dietary requirements
for this registration?
Private Vehicle Use
Is Private Vehicle being used for this travel
If YES please refer to policy: Paying for travel arrangements - JCU Australia Under “Allowances” Also request
assistance from CHS Admin Team, for clarification.
ACCOUNT DETAILS
Account type
Account number
Balance
How much for this request?
DBA/IRA
SSA
Grant/ Project
General operating
Total
APPROVAL (for Academic Head/ Dean Use ONLY)
Please email this form to your Academic Head and “cc” chs.admin@jcu.edu.au.
Approved to use DBA/ IRA/ SSA / Grant or Project funds
Approved for additional funds - amount if different to request
Account code for additional funds:
Academic Head / Dean comment:
Dec
lined
Academic Head / Dean comment:
Signed – Academic Head / Dean
Date
How much?
click to sign
signature
click to edit
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