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Lesley Dean-Jones, Chair 2210 Speedway, Mail Code C3400, Austin, TX 78712-1738 • 512-471-5742

Request for Travel Authorization Form

(please complete ALL fields)

Today's date:

Name:

email:

UT EID:

Actual Depart Date



Actual Return Date



Reason for Request:

Conference Name:

Conference Location: City/State/Country

Actual Conference Dates:

Paper? Title:

How much will this trip cost? (approx)


Transportation:

Food:

Lodging:

Other:

How much are you requesting?

Are you requesting a Faculty Travel Grant?

(You must be FACULTY presenting a paper):

Yes
No



Disposition of Duties:

List abbreviation and course #, day/time and who will cover each.







Account number(s):
Please add if known -- VERY HELPFUL!

Additional Notes:

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