| Name |
|
| Department |
|
| Current Date |
|
| Event |
|
| Date(s) of Event |
|
| Location (city/state) |
|
| Your e-mail address |
|
|
|
| Preferred Travel Dates & Times |
| Departure (specify date & time/a.m. or p.m.) |
| Date: |
|
| Time: |
|
|
|
| With a return after (specify date & time/a.m. or p.m.) |
| Date: |
|
| Time: |
|
| I am seeking time off from work and/or funding to attend the event noted above. |
| Please Choose One: |
| Request funding and time off |
| Request time off only |
| Account Number (if known) |
|
|
It is in the interest of Information Resources that I attend because:
|
|
Projected cost (accuracy is essential!)
|
|
Transportation
|
Cost
|
| Airplane |
$ |
| Misc. Ground Travel (parking, mileage, taxi, shuttle) |
$ |
| Registration |
|
|
Registration Fee
Early Bird Rate
Early Bird Cutoff Date:
|
$ |
| Conference/Event URL |
| indicate if meals are included w/fee |
|
Lodging
Check if this is Actual Conference Reserved Lodging
|
$ |
| Meals (applicable only if overnight stay included) |
$ |
| Grand Total |
$ |
|
I have discussed this request with my Unit Manager:
Unit Manager Name
Yes
Please forward any descriptive literature and registration forms you may have regarding your trip to Erin Manuel.
|
|
|
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