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* 1. First Name

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* 2. Last Name

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* 3. Department

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* 4. Please select one:

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* 5. Please select one (at time of travel):

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* 6. Name of event you will be attending:

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* 7. Type of event (conference, workshop, etc.):

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* 8. Event sponsor:

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* 9. Scope of event (regional, national, international):

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* 10. URL of event (if available):

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* 11. Your role at the event (conference attendee, present paper, present poster, moderate session, workshop leader, workshop attendee, etc.):

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* 12. For those presenting or chairing a session, title of presentation or session

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* 13. Location of event (City/State or City/Country):

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* 14. Starting date of event:

Date

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* 15. Final date of event

Date

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* 16. Date you are departing for the event:

Date

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* 17. Date you are returning from the event:

Date

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* 18. Does PDAC have permission to publish your abstract on the College PDAC website?

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* 19. Are you receiving any support external to the college to attend this event?

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* 20. Justification/rationale: How will the event advance your professional development?

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* 21. Have you received PDAC professional travel support within the last two academic years? If so, briefly describe how the conference/event/activity advanced your professional development. Include citations for any resulting publications, etc.

REIMBURSEMENT REQUEST

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* 22. Registration Fee ($600 maximum). Please include dollar amount only, no text:

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* 23. Lodging Calculations - per diem lodging for the city you are visiting. To look up copy the link: www.gsa.gov/portal/category/100120 - $77/day international, default rate

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* 24. Number of days lodging you need (evening before conference/workshop through last day of conference/workshop only, maximum of four nights)

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* 25. Meals and incidental expenses (MIE) calculations - per diem MIE for the city your are visiting. To look up copy the link: http://www.gsa.gov/portal/category/100120 - $46/day international, default rate

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* 26. Number of days Meals and incidental expenses (1/2 day for each day of travel plus days at the conference, maximum of five days)

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* 27. Transportation ($600 maximum. Please estimate air/rail fair using an online travel site. For personal auto - $0.57/mile. see other restrictions, PDAC Guidelines):

Checklist

*Did you receive permission from your department chair/supervisor for professional travel prior to submitting your application to PDAC? (Signature on this application no longer required as the chair approves the Travel Authorization)

*Did you fill out the application completely?

*Did you confirm that the information on this form is accurate, to the best of your knowledge?

 Did you know? The following are available near the bottom of PDAC Travel Funds web site: Guidelines, details of NYS allowable expenses (NYS Travel Manual); needed forms; directions for completing Travel Authorizations, Expense Reports, and Approving (chairs/supervisors); a list of department travel liaisons; materials provided by the Central Office; description of Expense Types; and International Country Codes.

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