REQUEST TO TRAVEL FORM
Group: Funding Board/Department:
Contact Name: Phone: Email:
Destination: Purpose: (City and State) (Conference, Convention, Annual Meeting)
Date of Departure: Time: AM PM
Date of Return: Time: AM PM
Registration Fee: $______ x ___ (# of students) = $_______total Due Date: _________________________
Website/Address: __________________________________ Payment Method: ___________________
(Credit Card or Check)
Method of payment: □ Direct from University □ Individual(s) □ Student Organization □ Advisor
*Attach registration forms
Transportation Method:
□ Personal Car $_________ □ Air $_______ □ Train/Bus $_______ □ Rental (see below)
# of vehicles _____ # of tickets _____ # of tickets _____ # of vehicles _____
Rental Vehicle Company _________________________________ Telephone#____________________________
Company Address _____________________________________________________________________________
Date of Reservation ______ Name of person(s) who made reservation __________________________________
Rental Vehicle Cost per day: $________+ Tax $______ ( ___% tax rate) = $_________total
*Attach list of drivers/passengers, itinerary (airfare, train, bus), quotes, contract, etc.
Hotel: _________________________________________ Telephone#____________________________________
Hotel Address: ______________________________________
________ Tax ID#___________________________
Cost of Hotel per night: $___________+ Tax $______ ( ___% tax rate) = $__________ total
(If different rate) $___________+ Tax $______ ( ___% tax rate) = $__________ total
Indicate: __________ # of nights of stay __________ # of rooms reserved
Total for Entire Stay: $_____________ Amount Funded by Funding Board: $ ___________________________
Date of Reservation ______ Name of person(s) who made reservation _______________________________
*Attach hotel quote with confirmation number and total price
Other Expenses to be Considered provide detailed explanation if miscellaneous:
Taxi Expense $________ Parking Fees $___________ Miscellaneous $________________
TOTAL COST OF TRAVEL $_______________ TOTAL AMOUNT FUNDED $_______________________
JUSTIFICATION FOR TRAVEL
(How does this benefit your group? What will you gain? What is the advantage to FAU?)
____________________________________________________________________
________________________________________________________________________________
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REQUIRED TRAVEL INFORMATION
Student Name
Z Number
Address
Phone
FAU
Email
* Code of Conduct & Procedure Agreement
¨ Attached
¨ On File
* I have read and agreed to the Student Travel Code of Conduct/Liability Form and Travel Procedure Agreement for the 2009-2010 Academic Year.
REQUIRED PRE-APPROVALS
I certify all information is accurate and every student traveler is currently enrolled at FAU. I understand my entire student organization will be held accountable for not following Student Travel Policy, University Controller’s Office and SG Accounting and Budget Office Travel Policies and Procedures, even in my absence.
__________________________________________________________________________
Signature of Traveler Print Date
