SOE Travel Request Form

Requested By:*

First Name

Last Name

Request Date/Time*

:

Email*

Purpose of Travel: Be as detailed as possible. Indicate if you are a presenter at the conference.*

Departure Location (City, State, Country)*

Destination (City, State, Country)*

Departure Date*

Return Date*

Expense Estimate: Airfare cost via CBT*

Expense Estimate: Registration or Membership Cost*

Expense Estimate: Lodging Cost*

Expense Estimate: Meal (per diem)*

Expense Estimate: Vehicle rental (if needed)*

Expense Estimate: Mileage (.65 per mile)*

Expense Estimate: Parking at Airport*

Indicate which airport

Miscellaneous*

What account would fund this travel?*

SOE Travel Fund Professorship CHSE Travel Fund Academic Affairs Travel Support Other funding source