System Administration: Request for Travel Approval 
 
This form must be completed to request travel approval, and signed by the appropriate Vice Chancellor.  The completed form must accompany all pre-approved travel expense requests and all travel reimbursement requests before they will be processed. 
Please provide an overview of the travel plans: 
 
Traveler's Name 

Department/Unit 
 
Event/Activity 
 
Trip Date(s) 

Destination (City/State) 

Mode of Transportation (Air, Train, Auto)  

Total Trip Cost (detail below) 
 
Funding Source/Account Number: (U-wide, SysAdm, RF Indirect, non-state sponsor) 
 
Justification - why is this travel essential? 
 
  

 
Breakdown and Comparison of Costs: 
If air travel is requested to a destination for which driving or the train is a reasonable alternative, a comparison of the cost of the air travel versus automobile/train must be submitted with a written justification for why air travel is necessary. 
 
Item                                                                                               Cost
 
Transportation (airfare, train fare, mileage, car rental): 
 
Tolls, Parking: 
 
Taxis, Subways, Buses: 
 
Lodging (only allowed State rate): 
 
Meals (at per diem): 
 
Registration Fee: 
 
Other:  
 
TOTAL COST OF TRIP: $ 
 

 
 
Signature of Traveler:                                                                           Vice Chancellor Approval: 
 
___________________________                                                                   ____________________________ 
 
Date:         _____________                                                                        Date:     _____________ 
 
 
Travel Approval Form October 26, 2010