Name:
Today's Date:
EID:
Title:
Email:
Current Home Address:
Travel Dates: Begin: End:
Destination: City: State: Country:
REQUIRED INFORMATION:
Name of meeting, convention, conference, event, etc. (DO NOT USE INITIALS):
Do you teach this semester? Are you scheduled to teach a class while you are away?
GRAs, TAs: Do you have permission to travel from your supervisor?
Supervisor's Name:
(REQUIRED—May NOT be a TA):
Name of FACULTY MEMBER responsible for your classes AND/OR duties:
Will you be presenting a paper, poster, collaborating, consulting, etc., etc., etc.,….?
How many people (from the Psychology Dept.) are going?
PURPOSE OF TRAVEL:
01 Attend meeting, conference, etc. 02 Conduct lecture or teach course 03 Perform research activities 04 Serve as expert witness 05 Present original research paper 06 Fundraising 07 Negotiate a contract 08 Prospective employee 99 Other:
ESTIMATED COSTS:
Meals: Lodging: Transportation: Other: TOTAL:
BENEFITS TO UT (MORE THAN ONE MAY APPLY):
01 Help accomplish research objectives 02 Help fulfill contract provisions 03 Enhance grad/undergrad curriculum (advisors & administrators) 04 Enhance performance of job duties (training) 05 Raise funds for faculty/student support 99 Other:
DISPOSITION OF DUTIES (YOU MUST CHOOSE ONE):
Instructional
01 No Classes Missed
Administrative
02 Duties assumed by colleagues or staff 03 Duties require travel 04 Duties held until return 99 Other:
List the account(s) you wish to be reimbursed from:
Account(s): or No Cost to UT
