TRAVEL REQUEST
(For overnight travel only)
Not required if PDP approved
I understand that travel shall be performed by College vehicle, using College credit cards for gas, oil, and expenses.
If I drive my own vehicle when a College vehicle is available, I will not be reimbursed. If I drive my own vehicle
when a College vehicle is not available, I will be reimbursed mileage at the rate of 56 cents per mile. Subsistence
reimbursement is limited to $35 per day for in-state and $50 per day for out-of-state. Lodging will be reimbursed
for actual cost of reasonable, prudent rates (attach paid receipt). Excessive costs will be disallowed. Air travel will
be by coach or tourist class only. Note to Traveler: Please return this approved form with your voucher for travel
reimbursement. See page 2 for detailed instructions.
Name _______________________________________ 5-Digit Organization #___________
Purpose of Travel____________________________________
Destination ________________________________________________________
I Will Leave At _________________On_____________
Time Date
I Expect to Return _______________On_____________
Time Date
I Will Travel By:(Check One)
________ College Vehicle
________ Personal Vehicle at Mileage Rate-No College Vehicle Available (56¢ per mile)
________ Personal Vehicle at Mileage Rate-College Vehicle Available- (Not reimbursable)
________ Commercial Transportation____________________________
Mode (air, bus, etc)
I will be a Passenger or room with______ ________
(circle one or both)
EXPENSES:
Motel__________________ $________________
Name Nightly Rate (including tax)
Commercial Transportation $_________________________
Cost
Registration Fees $_________________________________
Other:__________________ $________________________
Itemize
(1)___________________________________________
Traveler’s Signature Date
(2)___________________________________________ (4)_________________________________
Division Chairman Signature Date Business Office Date
(3)___________________________________________
Institutional Officer Signature
Date Revised 1/1/2021
BUSINESS OFFICE USE ONLY
ESTIMATED COST
TRANSPORTATION $__________
MOTEL $__________
MEALS $__________
OTHER $__________
REGISTRATION $__________
TOTAL $__________
Departure Time Return Time
Meal In Out
State State
Before 6:30 am After 11 am
Before 11:00 am After 1:30 pm
Before 5:15 pm After 8:30 pm
Breakfast 8.00 10.00
Lunch 10.00 15.00
Dinner 17.00 25.00
TRAVEL REQUEST
Instructions
1. Enter the traveler first and last name.
2. The 5 digit organization code should be entered that is paying for the travel costs. If this is a grant, then please also
provide the 5 digit fund code.
3. The Purpose of Travel is either the conference name, meeting or other reason.
4. Destination is where the employee is traveling.
5. Provide the time and date when you expect to leave from the college and when you plan to return, Attach a copy of the
meeting/conference agenda to the form.
6. In the “I Will Travel By” section, please check one of the 4 options. If commercial transportation is checked, then
provide the type you are using.
7. Provide who you will be a passenger with or sharing a room with. If it is no one, then state “no One” in the field.
8. In the “Expense” section, provide the following:
a. The name of the motel/hotel and the nightly rate.
b. The cost of the commercial transportation (if applicable).
c. The registration fee cost.
d. Other required charges.
9. Please make sure all signatures are attained before sending to the Business Office.
Note: Use the most recent form.