Sandhills Community College
Travel Authorization and Travel Advance Request
Date of Request: _________________________ Driver’s License No.: (NC) _______________________
Nature of Request:
Out-of-state travel In-state travel
Traveler: _______________________________________
Employee Student Other
Department: ____________________________________ Source of Funds: _____________________________
Destination: ____________________________________ Purpose: _____________________________________
Dates of Meeting: ___________ through _____________ Title of Program: ______________________________
Date Leaving: __________ Hour: _____
am pm Date Returning: ________ Hour: ____ am pm
Other SCC Employees involved in travel: __________________________________________________________
Mode of Transportation: School Car or School Van Private Vehicle Airplane Car Rental
Estimated Expenses: Estimated Costs Advance
Lodging: __________ days
@ ___________ per day @ ____________ @ 75% ______________
*** State travel subsistence rates for lodging are: In-State - $75.10, Out-of-State - $88.70
Meals: __________ days @ ___
________ per day @ ____________ @ 75% ______________
Transportation:
(private vehicle only)
__________
<100 miles @ _________ $.58
Other:
___________________________________ $_______
Total: ___________ Total: _____________
Note: Due to State regulations, registration fees, tuition, and airline tickets needed in advance should be requested
using the “Tuition and Registration Fees Advance Request” form.
FOR SCC BUSINESS OFFICE USE ONLY
Advance of Funds: Amount $_______________________ Account #___________________________
Amount $_______________________ Account #___________________________
Travel Requested by and License Check Authorized by:
Action by Faculty Development Committee
FACULTY ONLY
______________________________ ________________
Approved for no more than $ _____________________ from
Traveler (Date)
______________________________ _____________
_______________________________ funds.
(Department Chair / Supervisor)
(Date)
Not able to fund because _________________________________
_____________________________ _________________
______________________________________________________
(Dean)
(Date)
(FDC Chairperson Signature)
_____________________________ _________________
______________________________________________________
(Date)
(Date)
*** Subsistence rates for meals are: In-State: B - $8.60, L - $11.30, D - $19.50 Out-of-State: B - $8.60, L - $11.30, D - $22.20
>100 miles @ _________ $.33
per mile _______ @100%
____________
per mile _______ @100%
Total trip miles
***100 miles round trip regardless the number of days.
Total advance
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Sandhills Community College
Travel Authorization and Travel Advance Request (pg. 2)
Name ___________________________Department_____________________________
Description of Activity __________________________ Date of Request_____________
Category: college course conference back-to-industry on-campus project workshop
other: ____________________________________________
Total hours required for participation in activity (excluding travel time): _____________
Will any of your classes need to be covered?
Yes No
If yes, how many classes must be covered: _________
Who will cover each class? ___________________________________________
PLEASE ATTACH SUPPORTING DOCUMENTATION/LITERATURE REGARDING THIS
ACTIV
ITY INCLUDING DESCRIPTION OF ACTIVITY, DATES, COSTS, SCHEDULE OF
EVENTS, ETC.
Why is it important for you to participate in this activity? How will your participation benefit the college?
PLEASE BE SPECIFIC. Attach additional sheet if necessary. Your request will be returned to you if
sufficient information is not provided.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
How wi
ll you share the information you obtain?
_________________________________________________________________________________________
_________________________________________________________________________________________
Department chairperson’s comments of support for projected activity:
_________________________________________________________________________________________
__________________________________________
_______________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Travel Authorization and Travel Advance Request Checklist
In order to save time in completing this form and processing your travel request, the following “checklist” was
developed. If you have questions when completing your “Travel Authorization and Travel Advance Request Form,”
please call ext. 3717. Submit “Travel Authorization” for each trip, even when there are no funds requested.
Receipts and a copy of Travel Authorization and Tra
vel Advance Request must be attached. Books and individual
membership fees must be reimbursed by submitting a memorandum with receipts attached to your immediate
supervisor and appropriate vice president.
Complete the
following items:
Date of Request: (date you complete the form)
Nature of Request: (check either in-state and/or out-of-state)
Traveler: (name of person traveling)
Dept., (the department in which you work), ex. “Business”
Source of Funds: (unit no., ex. 38800)
Destination: (city and state)
Purpose
: (workshop, class, etc.)
Date of Meetings, etc.: (beginning date and ending date), ex. “02/13/2011 to 02/15/2011”
Title of Program: (name of class, workshop, etc.)
Date Leaving and Time: (date and time leaving, including a.m. or p.m.)
Date Returning and Time: (date and time returning, including a.m. or p.m.)
Other Employees Traveling: (list any other employee traveling with you)
Mode of Transportation: (check applicable box)
Estimated Expenses: Lodging, Meals, and Transportation costs are based on State rates.
Lodging: (list no. of days and enter amount per day, including taxes, and total amount
for lodging. If advance is requested, complete last column, “Advance.” In-state Lodging:
$75.10 per day; Out-of-State Lodging: $88.70 per day)
Meals: (list no. of days and enter amount per day, and total amount of meals. If advance is
requested, complete last column, “Advance.” In-State Meals: Breakfast: $8.60; Lunch, $11.30;
Dinner, $19.50; Lodging, $75.10. Out-of-State: Breakfast: $8.60; Lunch, $11.30; Dinner,
$22.20; Lodging, $88.70.
Transportation: When round trip does not exceed 100 miles (regardless of number of days
traveled) employees can be reimbursed for mileage at 58 cents.
When round trip does exceed 100 miles (regardless of number of days traveled) employees can
be reimbursed for mileage at .33 cents.
This rate is set by the IRS.
Other Expenses: (If you do not want the registration fees, airline tickets, etc. to be paid in
advance, enter those estimated expenses in this area.)
Signatures – faculty: (traveler; department chair; Rebecca Roush) (all sign and date)
Signatures – staff: (traveler; supervisor, appropriate vice president) (all sign and date)