Travel Request Form
Uploaded by
jaimiTravel Request Form
Uploaded by
jaimiULS PRE-TRAVEL/WORKSHOP APPROVAL REQUEST FORM
(please refer to ULS Travel Policy, located on the Behind the Scenes page,
https://bts.library.pitt.edu/Policy%20and%20Procedures/ULS%20Travel%20Policy.pdf )
Traveler information:
Name:
Date:
Campus Address:
Phone:
Email:
Supervisor’s Name:
Supervisor’s Email:
Trip Information:
Name of Conference/Workshop:
Business Purpose:
Departure Date:
Return Date:
Destination (City/State/Country):
Notes (e.g., if dates include additional days for personal/business reasons):
____________________________________________________________________________________
Expense Reimbursement Estimate:
How much is the total cost of the trip? (refer to the GSA website for mileage and per diem rates,
https://www.gsa.gov/travel-resources )
Transportation:
Per Diem:
Lodging:
Registration:
Other:
Total estimated cost:
Yes No
☐ ☐ Is anyone other than ULS paying for all or part of the trip? If yes, please indicate who is
paying and what expenses are covered:
_______________________________________________________________________
☐ ☐ Are you requesting any funds from a grant or soft money accounts? (please check with your
supervisor). If yes, please include name/account number:
________________________________________________________________________
☐ ☐ Are you presenting?
☐ ☐ Are you chairing a committee?
Is this travel request for: ☐ YES professional development, or ☐ administrative travel? (for
administrative travel requests, supporting documentation, e.g. emails, etc., must be provided)
Please indicate any additional comments or information regarding your trip:
_____________________________________________________________________________________
_____________________________________________________________________________________
TO BE COMPLETED BY SENIOR ADMINISTRATOR:
Account Distribution IF using an 03, 04, or 05 account:
Account Number: ________________________________________________$ or %: ______________
Account Number: ________________________________________________$ or %:______________
NOTES: ____________________________________________________________________________
AMOUNT APPROVED: $_________________________
Approvals:
Supervisor: ______________________________________________________ Date:______________
AUL: ____________________________________________________________ Date:______________
Director of Administration: _________________________________________ Date: ______________
Please forward signed approval to Poonam Dhillon.
Requestor: Please keep a copy of this request form for your records. If you would like a fully signed
and approved copy, please contact Poonam Dhillon ([email protected]).
