Travel or Web-Based Request Form

Date of Submission

Date

M#*

Name*

First NameLast Name

Conference*

Sponsoring Organization*

Location*

Travel Date to Event*

Date

Travel Return Date*

Date

Conference Start Date*

Date

Conference End Date*

Date

Do you have any membership information? Special dietary restrictions? Any additional information to add?

Registration or Workshop Fee (Include any add-on fees) *

How will you be paying for this registration?

Please pay for my registration when my travel request is approved.I will pay for my registration with my personal credit card and request reimbursement.I have paid for my registration. Proof of payment for reimbursement is attached.

Proof of registration payment

If the Admin office is purchasing your registration, please enter the link here:

If additional add-on fees for events or workshops were added in with registration fee, please list title and cost here.

Number of travel days*

Number of non-travel days*

Mode of Travel*

Motor Pool VehiclePersonal CarAir TravelOther

Motor Pool Vehicle Pick Up Date*

Date

Motor Pool Vehicle Return Date*

Date

Pick Up Time*

Hour Minutes

AM/PM Option

Drop Off Time*

Hour Minutes

AM/PM Option

Will pick up or drop off before or after business hours? Please explain.

Number of people traveling*

Airfare Payment Method*

Birth date required for airline purchase. *

Please upload your first and second choice of air travel information.

Please upload your proof of payment for air travel, including flight information

Estimated Mode of Travel Expense: *

Do you have a travel rewards number to include?

Will there be over night stay?*

YesNo

Lodging Rate: *

Make sure to review the CONUS rates. https://www.gsa.gov/travel/plan-book/per-diem-rates

Hotel Check In Date*

Date

Hotel Check Out Date*

Date

Number of nights reserved*

Estimated Lodging Expense:

If you will want us to make hotel reservations for you upon approval, please upload any lodging information regarding special conference rates, hotel choice, etc. CONUS per diem rates

Please upload lodging information here.

Are there meals provided within the cost of your fee?*

YesNo

Estimated meal expense:

Do not include meals provided in conference fee.

Total of any miscellaneous fees:

For example: paring fees, or taxi, etc.

Total of estimated travel expense:

Email to Department Head (and/or supervisor) for approval: *

Request Form

Walker Library Travel Request

Conference Information

Travel Costs

Lodging and Meals

Web-Based Professional Development

Webinar or Online Course Information

Webinar or Online Course Costs