TRAVEL REQUEST FORM

TRAVEL AUTHORIZATION CONTACT travel@kysu.edu (502) 597-7010

In-State Out-of-State International Request for travel advance Yes No If yes, amount $___

To be reimbursed for travel expenses incurred while traveling on behalf of the University, this Travel Request Form must be submitted to the Travel Department at least 15 days prior to the expected date of travel. For international travel, the Travel Request Form must be submitted at least 30 days prior to expected date of travel. A separate form is required for each person requesting approval.

TRAVELER'S INFORMATION

Name _____ KSU ID# _____ Male Female

Department/Project ___

Telephone ___ Email ___

BUDGET(S)

Fund ___ Organization ___ Account ___ Program ___

Externally sponsored travel? ☐ Yes ☐ No If yes, Sponsor Contact ___

External Sponsor Telephone ___ Email ___

TRAVELER'S DESTINATION

ཞབས་ཆེན་ཆེན་ཆེན་

Destination ___ From Date ___ To Date ___

Conference/Meeting Title ___ No. of Students ___ (Attach Roster with KSU ID)

Purpose of Travel/Statement of Benefit numbers)

MODE OF TRANSPORTATION

Airline Train Campus Transportation Rental Vehicle Personal Vehicle

Airline Reservation Confirmed By: ☐ Traveler ☐ Travel Coordinator (charge via P-Card)

Departure Time _____ Return Time _____ Estimated No. Driving Miles _____

LODGING

Hotel Name _____ Address _____

Hotel Telephone Number of Room(s) ___

TRAVEL COST ESTIMATE

SIGNATURE APPROVAL

My signature below indicates that I understand and I am responsible for making good faith effort to secure the most economical and reasonable method of transportation, lodging and all other costs. I will certify that all costs incurred and reported by me for this period of travel is true and accurate in all respects.

REVISED 4/30/20