Travel Request Form

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• This form MUST be completed and submitted 2 weeks prior to travel dates.
• After filing out this request please complete necessary documents (W9 or W8/Wire Transfer). Check your e-mail for more details. These forms must be submitted as soon as possible to start reimbursement process.
• 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 (all federal agencies) or the Open Skies Agreement (NSF). Please choose carefully as there are restrictions on both regulations governing foreign travel on grants and contracts. Please ask if you have questions.
• Please check the accuracy of your request before submitting.

Personal Information

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UMD Employee *	Yes No	Do you have an SSN? *	Yes No
First Name *		Last Name *
Title *		Home Institution *
E-mail Address *		Phone *
Faculty Sponsor/Contact	OtherAdams, JeffreyBalan, RaduBedrossian, JacobBejleri, DoriBenedetto, JohnBerestycki, HenriBrosnan, PatrickBuckmaster, TristanCameron, MariaCerrai, SandraChen, LeiChen, XuemiaoChernikov, ArtemCristofaro-Gardiner, DanielCzaja, WojciechDarvas, TomasDe Rosa, AntonioDolgopyat, DmitryElman, HowardFayad, BassamForni, GiovanniFreidlin, MarkGholampour, AminGoldman, WilliamGrillakis, ManoussosGu, YuGulick, SidneyGumel, AbbaHaines, ThomasHamilton, DavidHanson, JamesHoganson, HannahHuang, XiaoqiHultgren, JakobIbdah, HussainJakobson, MichaelKanigowski, AdamKedem, BenjaminKoralov, LeonidKovacheva, YordankaLaskowski, MichaelLevermore, CharlesLevy, DoronLin, LizhenLyzinski, VincentMachedon, MateiMackall, EoinMargetis, DionisiosMellet, AntoineMelnick, KarinMoakler, ChristopherMograby, GamalNguyen, HuyNochetto, RicardoRamachandran, NiranjanRay, DeepRen, JoanRosenberg, JonathanRosendal, ChristianRubinstein, YanirSaegusa, TakumiSchafer, JamesSlud, EricSmith, PaulTadmor, EitanTamvakis, HarryTest, AaronTrevino, RodrigoTrivisa, Konstantinavon Petersdorff, TobiasWashington, LawrenceWentworth, RichardWu, YijingYang, HaizhaoYushutin, VladimirZelerowicz, AgnieszkaZhang, BoyuZhu, YihangZickert, Christian	Other Sponsor/Contact *

Trip Information

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Please specify airport/rail station codes for the "Travel From" and "Travel To" fields
Travel From *		Travel To *
Departure Date *		Return Date *
Destinations *	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).

Estimated Expenses

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Name of Airline/Train (if on a Grant, Foreign Travel must be a US Carrier)
Ground Transportation
Personal Car	Miles
Lodging	Will you be needing hotel accomodations? Yes No
Per-diem	Yes No
Other	Use this for conference fees or other expenses not account for in the above sections. Please explain in the notes section below
Notes	Please enter any additional information the business office may need to know in order to process your request.

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Please only click the Submit button once to avoid duplicate entries. Please check your e-mail for additional forms and next steps.