Travel Reimbursement





Request for Travel Reimbursement
This form must be submitted within 30 days no matter what the source of funds

Name: ____________________________________________ E-mail address:______________________________________

Source of funds (ie research funds, department travel, etc.) ________________________________________________

Dates and Times of Travel: _______________________________________________________

Name and Location of Conference:_________________________________________________________________________

Purpose of Trip (ie present paper, participate in round table, etc):______________________________________

US Dollars Only!! (exchange rate: $___________________)


Registration: $___________________________  Taxis or Metro (circle one): $____________________________

Airfare/Bus/Train (circle one): $___________________________________________________________

Vehicle Expense: Personal Vehicle Mileage or Rental Fee:___________________________________________________

Parking: $ ____________________ Tolls: $ ________________________________


Miscellaneous (itemize) including baggage fees and cabs:_____________________________________

Did you stay at the conference hotel? yes no

You MUST include your boarding passes and itinerary with this request.
If you wish to be considered for additional reimbursement at the end of the year you MUST include ALL meal receipts.


(The Travel Administrator will calculate meals and incidental expenditures by using the rate guide which allows a specific amount based on location. If you would like to be reimbursed only for your actual expenditures rather than the per diem allowance, please make a note about the amounts on the bottom of this form. Click here if you would like to see the rate guide.

Lodging #1 (nightly rate) $ _____________________  Taxes $ _______________________

Lodging #2 (nightly rate) $ _____________________  Taxes $ _______________________

Lodging #3 (nightly rate) $ _____________________  Taxes $ _______________________

Lodging #4 (nightly rate) $ _____________________  Taxes $ _______________________