Name: Date of Request:
Department/College: Title:
Traveler Signature: Are you presenting? Yes No
Dates of Travel: International Travel? Yes No
Please register international travel at
http://niu-travel.terradotta.com/
Destination:
Conference/Organization Name:
Title of research paper or description of other activities (pleas
e limit to two lines or attach additional sheet if necessary)
Is travel over break or weekend? Yes No
Name/Contact of person who will perform duties if during work week
Attach a copy of the proposal you submitted and the acceptance letter from the conference.
If you are not presenting, attach a short (one page maximum) narrative describing the benefits of this
travel to you, the department and/or the college.
Estimated Cost Requested Support
Transportation $ Department $
Food, lodging and other expenses $ College $
Registration fees $ Grant** $
Total $ Other** $
Total $
** Attach a short narrative describing the source of funds and outline with cost center and signatures below.
Approved Support:
(Please make sure all fund sources are signed off before submitting to your College Dean/Unit VP for final approval.)
Department $
Cost Center # Department Chair Signature Date
College $
Cost Center # College Business Manager Signature Date
Grants Fiscal $
Grant & Cost Center # Grant PI or Co-PI Signature Date
Other $
Other Name & Cost Center # Fund Advisor/Administrator Signature Date
Travel Support Approved:
In accordance with NIU Travel Guidelines and Restrictions (Executive Order 15-08). Request is approved if signed below. If not approved,
please explain:
_____________
Dean/Unit VP Signature Date Revised 10/25/19
REQUEST FOR SUPPORT FOR PROFESSIONAL TRAVEL
(Submit to College Dean or Unit VP for Final Approval)
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