College of Educational: Educational Psychology



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TRAVEL FUNDING REQUEST FORM

This form MUST be submitted to the EPS Office and approved before the start of travel.

No university funds can be utilized towards travel expenses prior to approval.

Name:       EMPL ID#:       Date:      

Please check only one box: Faculty/Staff Graduate Assistant Student/Non-NAU Employee

|CONFERENCE/WORKSHOP/MEETING/EVENT FOR WHICH FUNDS WILL BE USED: |

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|Date(s) of Travel:       |

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|Personal Travel Incorporated into Trip? If yes, list dates (additional documentation may be required):       |

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|FULL Title of Conference/Workshop/Meeting/Event:       |

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|Location:       |

|NATURE OF ACTIVITY AT TRAVEL DESTINATION: |

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|RATIONALE/PUBLIC PURPOSE FOR TRAVEL SUPPORT (how does this travel benefit the following: Professional Development, EPS Department, EPS Department Programs, College|

|of Education, Northern Arizona University) – be specific: |

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|AVAILABLE FUNDS: |

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|Professional Development Account Balance: $       |

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|Additional Source(s) of Funding for This Trip: |

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|Source #1:       Amount: $       |

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|Source #2:       Amount: $       |

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|REMINDER: If you have secured funds from other sources; i.e., COE Dean’s Travel Award, GSG, etc., please attach the travel fund award letter/notification. |

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|PROJECTED TRAVEL COSTS: |

|Airfare: $       EPS To Arrange Traveler to Arrange Shuttle/Parking: $       * |

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|Conference Registration: $       EPS To Arrange Traveler to Arrange Mileage: $       * |

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|Hotel: $       Other: $       |

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|Meals: $       |

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|* For vehicle related expense reimbursement, traveler must be a university authorized driver |

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|REQUEST TOTAL: Total Amount Requested: $       |

|REQUIRED SUPPORT DOCUMENTATION (attach the following to this form): |

|Airfare Receipt and itinerary (if paid for by traveler); If incorporating personal travel days within the trip, you must submit two airfare |

|quotes providing proof that the personal travel days did not increase the expense of the airfare (Travel Policy: TRV 530-01) |

|Copy of Conference Agenda/Schedule (if electronic – traveler is responsible to submit pdf or print) |

|Conference Registration Receipt (if paid for by traveler) |

|Documentation of Conference Hotel and Hotel Rate; MANDATORY whether you’re staying at the conference hotel or not; this document is |

|used in several ways in the pre/post-travel approval process |

|Copy of Conference Presentation/Poster Acceptance Letter/Email |

|FOR OFFICE USE ONLY: | |

| |If I fail to settle my account, I authorize NAU to deduct the balance against my |

|Travel Certification Form on File – Current AY (Driver/Non-Driver) |wages. (A.R.S. 35-192.02B) |

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|____________________ | |

|Area/Org. to be Charged | |

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|____________________________________________________ | |

|Department Chair Signature (electronic signature NOT allowed) |__________________________________________________________ |

| |Traveler Signature (electronic signature NOT allowed) |

REVISED: HGD, 1-18-2020

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