Faculty/Staff Request for Travel Funding Please refer to the Travel Policies and Procedures in the Faculty/Staff Handbook. First Name Last Name Email Purpose of Trip - Select - Recruiting Professional Development How many prospective students do you anticipate connecting with? Numbers only, please. What materials would you like us to send with you? Travel Brochures Swag (Pencils, Lip Balm, Fidget Stickers) Audition Day Posters Fliers with QR codes leading to an online “Request for Information” form SoM tablecloth Informational Tabletop Displays Select all that apply. Destination Date of Departure Date of Return Describe Intended Outcomes Provide a full explanation of your trip and proposed outcomes. If attending a conference, include a link to the conference website. Estimated Expenses Note: Please consult the University Travel and Business Expense Policy before completing the estimated travel expense form below.• Use only numbers• Round up to the nearest whole number (no decimals, please)• Total must not exceed 3500• All fields must contain a value. Enter "0" if no expenses apply. Airline ticket, economy class Personal Car / Rental Vehicle Lodging (# of nights x $ per night) Are you staying at the conference hotel? - Select - Yes No Meals / Per Diem (Number of days x Daily Per Diem) Registration Fee Other Expenses (tips, etc.) Reimbursements • Use only numbers• Round up to the nearest whole number (no decimals, please)• Total Reimbursements will be deducted from Total Estimated Expenses Anticipated payments/honoraria Expenses Reimbursed from Other Sources Funding available from other university resources (Excellence fund or other) Total Estimated Expenses: