Travel and Professional Development Request Form
Request for Funds
For travel funds ATTACH ALL TRAVEL DOCUMENTS (hotel, registration fee, airfare, mileage map, conference agenda, etc.)
Submit your request a week or more prior to the next PDC Meeting for their consideration. (See published meeting schedule.)
Your request will be reviewed
at the PDC meeting. You will be notified by the PDC Co-Chairs of the committee’s decision. NOTE:
There is a $1000 maximum per applicant/year.
Once approved, create a TA in PeopleSoft. Scan and attach this approved form and the supporting documents with your entry.
If you need assistance, please contact the Business Office Travel Liaison at X 7401.
SECTION 1: Is Funding Source from outside the PD Committee? Yes No Source:
First Name: Last Name:
Empl. ID #:
Date:
Job Title: Email: Mgr:
Dept.
Phone:
Is a Sub Needed?
Yes No
Organizational Sponsor: Member of Organization Yes No
SECTION 2: Select Appropriate Request Avenue
Title of Activity
Travel/Conference
Event Project Presentation Other
SECTION 3: to be completed for Travel/Conference expenses only
Travel Inclusive dates:
From: To:
Conference
Location
Detailed Expense Items
$ Amount
Mileage: Distance
from Miramar College
to Event
Current reimbursement rate 0.575 X RT
Miles Enter Total Round Trip Miles
(rounded to nearest whole number)
Registration Fee
Pre-Pay (District) Employee Paid
Airfare
Pre-Pay (District) Employee Paid
Hotel/Lodging
Pre-Pay (District) Employee Paid
Auto Rental
Gas for Rental
Miscellaneous
Estimated costs (taxi, shuttle, parking, luggage, etc.)
Internet
For college business only
For Meals NOT included
at the Conference*
* Meal reimbursement for travel within San Diego County is NOT permitted per District Policy
Total Travel Expenses:
Amount Requested
from PDC (max 1000):
$
Amount Requested
from Other Source:
Budgets Numbers: PD: Other
APPROVAL SIGNATURES
Dept. Chair/Supervisor Signature(below)
Date
Dean/Manager Signature (below)
Date
PD Committee Signature (below)
Date
Vice President’s Signature (below)
APPROVED PROPOSAL FORM MUST BE ENTERED IN PEOPLESOFT AND APPROVED PRIOR TO TRAVEL
You will receive a system-generated email notifying you once your travel has been OFFICIALLY approved.
Cell:
AMOUNT APPROVED $
Date
$
Revised 9/18/19 - Business Office - CD
Stat
e
City
Reimbursement for
mileage may not
exceed the total cost of
coach airfare.
Complete the Meal Reimbursement Breakdown chart on
the top of page 2 and then enter the Grand Total here.
Attach all Supporting
Documents to this
request before
turning it in for
approval.
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0.00
San Diego Miramar College 2013 2020
Strategic Plan Goals
I
: Provide educational programs and services that are responsive to change and support student learning and success.
II: Deliver educational programs and services in formats and at locations that meet student needs.
III:
Enhance the college experience for students and the community by providing student-centered programs, services and activities that
celebrate diversity and sustainable practices.
IV: Develop, strengthen and sustain beneficial partnerships with educational institutions, business and industry, and our community.
Section 2: Goals: Please describe how your involvement in this request would support the College Mission and/or
the Strategic Goals of Miramar College.
Section 3: Outcomes and Deliverables: Please identify:
a) the beneficial outcomes of this proposal and b) the
deliverables of how this could positively impact Miramar College and/or the District.
Complete Sections 1-3 for PDC F
und approval only (1000 character limit in
each field)
Section 1: Overview: Please provide a succinct description of your Proposal for Professional Development
MEAL REIMBURSEMENT BREAKDOWN CHART
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0
0
0
0
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