TRAVEL REQUEST FORM
Item
Data
Travel Year (Academic Year)
Faculty/Staff Name
Rank (Title)
Academic Unit
Name of Conference/Meeting
Location of Conference/Meeting
Date(s) of Conference/Meeting
Mode of transportation (ground, air)
Estimated Costs*
*The School of Health Studies will reimburse up to $1000 in travel costs per academic year for faculty members. Funds exceeding
the above figures can be paid via individual faculty grants or online funds (assuming the applicant has such funds available).
Regardless of funding source, this travel request form must be completed before all travel.
NOTE: International travel requests should be submitted two months in advance of the planned trip.
In the space below, please provide a specific description of why you will be attending this conference/meeting.
Potential reasons may be multiple and may include, but may not be limited to:
 Providing a main lecture or tutorial
 Presentation of data
 Meeting with funding agency representatives
 Data collection or research work
 Committee work (elected officer or otherwise)
 Promotion of academic programs
 Professional development to improve job-specific skills used regularly within the school
If applicable, you should include details of how your attendance at this conference/meeting will benefit the School of
Health Studies.
School funded:
Applicant Signature
Date of Request
Account #:
Amount: $
Director’s Approval
Date of Approval
YES
NO