Rev. 2/19
Louisiana State University
Office of Accounting Services
Accounts Payable & Travel
217 Thomas Boyd Hall
REQUEST TO TRAVEL TO RESTRICTED REGIONS FOR INDIVIDUAL TRAVELERS AS295
Instructions: At least 30 days in advance of the proposed travel, please complete all pages of this form (attaching
additional pages, if necessary), obtain the required signatures on page 1, send to the International Travel
Oversight Committee (ITOC) in care of Director of Accounts Payable & Travel (217 Thomas Boyd Hall
or pgremill@lsu.edu), and the final approved version must be attached to the Spend Authorization in Workday.
Traveler Details
Name: LSUID: E-Mail
: ___________
Title: Phone: _________________
Department: Department Mailing Address: _
Business Manager: E-Mail: ___ _
Description of Travel
Purpose of Proposed Travel:
Location (list all countries and cities –be specific):
Travel Advisory of Restricted Region (circle one): LEVEL 3 4
Exact Dates of Proposed Travel:
Required Signatures
Traveler Name (please print): _
Traveler Signature:
Date:
_
Director/Dept. Head/Chair Signature: Date:
Dean Signature: Date:
ITOC: __________ Recommends approval ___________ Does not recommend approval
Associate Vice President: _____________________________________ Date: ___________________________
________ Approved ________ Denied VP for Academic Affairs: ____________________________________