School of Music Travel Information/Financial Request Form*
Name__________________________________ Title/Position___________________________
EMPL ID______________ Campus Email _________________Phone____________________
Destination____________________________________________________________________
Purpose_____________________________________________________________________
(Performance, Teaching, Master Class, Recruitment, Lecture, Conference, Other?)
Date of Submission _________________________
Dates of Travel_____________________________
Anticipated costs:
Air Transportation $________________
Ground Transportation $________________
(taxi, rental car, gas, etc.)
Lodging $________________
Meals $________________
Registration Fee $________________
Other $________________ (Specify________________)
Total Cost $________________
I have completed & submitted a PTT form for Domestic Travel.
I have completed & submitted an international PTT form at least 90 days prior to this trip.
Sources of Financial Support
School of Music
Other
$________________
$________________ (Identify Source ____________________)
International Education $________________ (If applicable)
Total $________________
(Complete Other Side)
(Date for Priority Consideration - September 15)
Please list the cities, organizations & individuals that you will be visiting/meeting on this trip:
______________________________________________________________________________
Please list the activities that you will be involved in at each location:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Will you be auditioning prospective students while on this trip? Yes No
Expected outcomes (students coming to study at USM, faculty exchange program, etc.):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________
Date
_______________________
Date
_______________________
Date
________________________
Faculty Member’s Signature
_________________________
Director’s Signature
_________________________
Center for International Education
(If Applicable)
*- Note: This form is NOT a substitute for the regular USM Permission to Travel (PTT) form.
The PTT form must be completed as well.