Mathematics Department Travel Request

PLEASE SUBMIT 3 WEEKS PRIOR TO DEPARTURE ***Will not be submitted to Chair for Approval until the form is complete � every blank even if you are not requesting funds!!!***

Employee Name:_____________________________________ASU ID#:__________________

Account Name:______________________________________Account No.:________________

Inclusive Dates: From:_______________To:______________Destination:_________________

Classes/Obligations assumed by:___________________________________________________

Class:____________Place:___________Time:________Date:________Covered by:__________

Convention Meeting Dates (if any): From:________________To:________________________

Transportation funded by (if other than ASU funds):____________________________________

Personal Vehicle:__________(Auto mileage cannot exceed air coach fare):______Mi@____Mi $___________

Plane Fare___________________________ $___________

Taxi___________Bus__________Limo___________Train___________ $___________

Per Diem (Meals and incidental expenses)_________days@_________$/per day $___________

Lodging:_________night@_________$/night $___________

Registration Fees $_________Parking $___________Rental Car $_________ $___________
(Rented Auto Justification required below)

TOTAL ESTIMATED COST $___________

AIRLINE TICKETS: Was on campus agency used? q yes q no

If yes, how was agency paid? q By credit card/cash q Direct by ASU to Agency

Purpose/Justification: (How ASU/STATE project will benefit). If more than one person is attending the conference/meeting, indicate so and justify. If car will be rented show justification. Attach additional sheet(s) if necessary.

Cash Advance requested: q yes q no Check q Traveler Checks q

Air Fare(100%)________________ Remainder (75%)______________

Approved: Yes__________ No_________

_____________________________________
Dieter Armbruster, Chair