Travel Request
*First Name
*Last Name
*Email
*Classification
Cell Phone
(required by travel agency, if traveling by plane)
*What Conference/Meeting are you going to?
*Will you give a talk?
*Is the talk an invited talk?
How long will the talk be?
Additional purpose?
*Departing from?
*Departing when? --
*Destination City?
*State?
Country?
*Returning when? --
Any time constraints for departing/returning?
*Travel Arrangements
Estimated Expenses
Airfare
Auto
Personal or State vehicle
Lodging
Meals
Registration
Other Expense 1
Other Expense 1 Cost
Other Expense 2
Other Expense 2 Cost
Other Expense 3
Other Expense 3 Cost
Total Expenses
Funding Sources
Use Grant
Amount from Grant
Requested from Non-UNL
Requested from College
(additional form required)
*Requested from Dept.
(required, even if it's $0)
Personal funds
Total Funding
* denotes required field