In-Person SB Pre-Travel Form
To ensure sufficient funds are available for reimbursement, this pre-travel form must be completed and submitted to the SB Coordinator for approval prior to traveling. Expenses incurred without pre-approval will not be reimbursed.Although the review and approval of SB travel usually only takes up to five business days, it is advisable to submit the form for approval as early as possible to avoid unforeseen delays.
Name:
*
First Name
Last Name
Email
*
example@example.com
How many trips have you requested this year including this one?
How many lectures will you be including on this trip?
*
Please Select
1
2
3
4
5
Please use one form for a trip with multiple lectures.
Travel Date:
*
-
Month
-
Day
Year
Date
Trip Duration:
*
Number of Days
Lecture 1
Destination:
*
Chapter Name:
*
Estimated Number of Attendees:
*
Talk Title:
*
Lecture 2
Destination:
*
Chapter Name:
*
Estimated Number of Attendees:
*
Talk Title:
*
Lecture 3
Destination:
*
Chapter Name:
*
Estimated Number of Attendees:
*
Talk Title:
*
Lecture 4
Destination:
*
Chapter Name:
*
Estimated Number of Attendees:
*
Talk Title:
*
Lecture 5
Destination:
*
Chapter Name:
*
Estimated Number of Attendees:
*
Talk Title:
*
Estimated Total # of Attendees:
*
Estimated Total Travel Expenditures:
*
In USD
Estimated Local Chapter (and Other) Support:
*
In USD
Estimated IEEE MTT-S Support
*
In USD
Additional Information (if have)
*
You may provide additional information here to help the coordinator make the decision.
Submit
Should be Empty: