Travel Request Form

This form MUST be completed and submitted 2 weeks prior to travel dates.
AFTER the trip, please fill out a TRAVEL EXPENSE FORM and SUBMIT with ORIGINAL RECEIPTS within 14 DAYS of your return.
Foreign travel must follow either the Fly America Act or the Open Skies Agreement. Please choose carefully as there are restrictions on both regulations governing foreign travel on grants and contracts. Click the link for more information: www.ora.umd.edu/resources/foreign-travel
Please check the accuracy of your request before submitting.

Personal Information

UMD Employee

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Yes No

Department

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Last Name

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First Name

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If you are a foreign national please complete the information below:

Country of Birth		Type of Visa
Country of Citizenship		Home Institution

E-mail Address

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Phone

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Faculty Sponsor/Contact

Other Sponsor/Contact

Trip Information

Please specify airport/rail station codes for the "Travel From" and "Travel To" fields

Travel From

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Travel To

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Departure Date

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Return Date

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Destinations

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Does this itinerary include multiple destinations? Yes No

Destination Info	In the box below, please list each destination and the date you will reach that destination. Please use a new line for each destination. (example: Washington DC - 10/25/16)

Purpose of Travel	Please inlcude the URL for the conference and title of your presentation (if known).
Travel Agency

Estimated Expenses
Name of Airline/Train (if on a Grant, Foreign Travel must be a US Carrier)
Ground Transportation
Personal Car	Miles x ~ =
Lodging	List of preferable hotels close to campus.
Per-diem Location	Domestic International
Meals	Days x ~ = * If your visit included our hosting meals and depending on circumstances, we may not reimburse a per diem.
Other	Use this for conference fees or other expenses not account for in the above sections. Please explain in the notes section below
Total Estimate
Notes	Please enter any additional information the business office may need to know in order to process your request.

Funding Source *

Please only click the Submit button once to avoid duplicate entries.

Travel Request Form

Personal Information

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Trip Information

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Estimated Expenses

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