OUT-OF-STATE TRAVEL REQUEST FORM

Please use mm/dd/yy for all date formats.
 Today's Date Departure Date Return Date
Traveler's Name
K-State EID Lab

Will reimbursment come from KSU funds? Yes No
This includes state and grant funding. If you have any questions, please talk to the professor. If you select no, please include where the money will come from in the additional comments box below.
 If yes, which account(s)? Must enter actual account number(s).
Will you be using personal leave during your travel time? Yes No If so, what days? *

Who else will be traveling with you? (Please list name and department)
Name
Department
Name
Department
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Please Include Any Additional Comments Here:

*****Information needed below for reimbursement!!*****

Meeting Information:

  • First Meeting Location:
    • (City & State or Country)
    Beginning Meeting Date * Ending Meeting Date *
    Purpose for Traveling: (ex. to attend meeting entitled.., to meet with scientists at...to perform experiments at...)


  • Second Meeting Location:
    • (City & State or Country)
    Beginning Meeting Date * Ending Meeting Date *
    Purpose for Traveling:

  • Third Meeting Location:
    • (City & State or Country)
    Beginning Meeting Date * Ending Meeting Date *
    Purpose for Traveling:

    Will you be making a presentation? Yes No ...... If yes, what type of presentation?
    oral presentation
    poster presentation
    workshop
    seminar
    other
    none

    Title of presentation:

    Are You Receiving any Awards? Yes No ......If yes, please list amount and sources:

    Estimated Costs:
  • Travel
    		•
    Will you use: (check as many as apply and give estimated cost)
    Type of Transportation Estimated Cost of Transportation
    Personal Car
    Riding with Other Individual (name whom)
    Air Travel
    Roadrunner Shuttle
    Rental Car
    State Vehicle
    Train
    Bus
    Taxi

  • Lodging: Rate per Day
    		•  (Not Including Taxes)
  • Registration Fee
    		•
  • Are meals included in registration fee?
    		•  Yes No
  • Expected Miscellaneous Costs (i.e. abstract fees, visas, etc.)
    		•  Please list expense and estimate cost for each, if none enter "None".

    Miscellaneous