ALVERNIA COLLEGE
DEVELOPMENT AND RESEARCH COMMITTEE
TRAVEL REQUEST


First Name: 
Last Name: 
Department: 
Campus Address: 
Phone Extension: 
Name of Event: 
Location: 
Date of Event: 
Your Email Address: 

Type of Event

A)  Conference   Workshop/Seminar   Other: 

B)  International/National   Regional   Local   Other: 

C)  Presenting   Attending   Other 

Brief description of event to be attended and your purpose for attending it, if presenting indicate title of paper. (Provide supporting documentation.)

Estimated Departure Date:

Estimated Return Date:

Estimated Cost:

Conference/Event Fee:

 

Transportations:

Air Fare:
Personal Auto (at $.445/mile):

Lodging:

Name & Location:
Estimated Total Lodging:

Meals ($35/day limit):


Miscellaneous Expenses:


(Identify)

Total Estimated Expenses:

     


You must have receipts for all your expenditures, INCLUDING MEALS, to be reimbursed.

Other sources of financial aid and amount requested/approved:

From Department or Other Sources:

Amount Referred to Committee:




Email of Department Chair, or Division Dean:
(A copy will be sent to your Chair/Dean for approval)

 


After the Trip


To complete your application, you MUST send your supporting documentation (cost of hotels, plane tickets, etc) to Phyliss Hay in BH 125-3.


      

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