Faculty and Staff Travel Request ( Short Version)

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* 1. Requester's name ( Last Name, First Name, please.)

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* 2. Purpose of travel

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* 3. Today's date

Date / Time

Date

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* 4. Last name of requester’s supervisor/division chair

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* 5. Faculty or Staff?

I am faculty (go to question 6)

I am staff (go to question 8)

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* 6. Faculty only - will you be an active participant in this event? (giving a paper, serving on a panel etc.)

Yes

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* 7. Faculty only - have you received previous travel support for this fiscal year?

Yes

I don't know.

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* 8. Requester's Department

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* 9. Destination City

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* 10. Destination State

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* 11. Destination Country

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* 12. Start date of travel

Date / Time

Date

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* 13. End date of travel

Date / Time

Date

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* 14. Total estimated expenses for this trip

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* 15. Please enter the account number(s) to use for charges (no spaces, no dashes) and the amount requested for each account. Faculty, note that the account number for Professional Conferences/Papers is 10140124062000.

Account Number / Name of Account / Amount

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* 16. Total amount requested for this trip

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* 17. Will a College purchasing card be used for this travel?

If personal travel is included: The purchasing card may not be used for airfare and a valid cost comparison must be obtained for what the airfare would cost if traveler were flying only on official Westminster business. The cost comparison must be completed and printed on the same day the airline ticket is purchased.

Signature of Traveler: Electronic submission of this document is accepted as traveler's signature.

Signature of Supervisor/Division Chair: _____________________________________ Date: _______________

Signature of Vice President: ______________________________________________ Date: _______________

Account #: __________________________

Amount Authorized: ___________________________

Account #: __________________________

Amount Authorized: ___________________________

Account #: __________________________

Amount Authorized: ___________________________

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