Western Illinois University
Request for Travel Req. No. ____T
Contact Person: Date:
Address:
Name of Person Traveling:
Destination of Trip
Beginning and Ending Dates of
Travel Purpose
Trip Summary Amount
Registration fee
Travel to be paid by PCard
Amount to be reimbursed to Traveler
State car
Total
Cost Center Name:
Cost Center Number:
Amount Authorized:
Cost Center Name:
Cost Center Number:
Amount Authorized:
NOTE: Employees who report to a division in Academic Affairs need to attach a justification for the travel that
includes a breakdown of the costs (hotel, transportation, Per Diem, registration, etc.) and the level of participation
(attendance only, panel presentation, formal paper presentation, other). The reimbursement for professional travel
should reflect the level of participation of the applicant. All statements of justification need to be routed through the
appropriate dean, department chair, or director’s office for comment, approval, and signature.
Fiscal Agent Signature:
President/VP/AVP Signature (if required):
Instructions: Requests for Travel must be for one individual for one trip. Requests for Travel must contain the proper
signatures (see below for employees in Academic Affairs). PCard payments for travel expenses must reference the
Request for Travel in the comments section of the respective pcard transaction. Attach a copy of the Request for Travel
to DPAs and Travel Vouchers.
