Pre-Travel Request Form This form must be completed before any out of state travel for the School of Social Work. If this form is not completed then the School cannot guarantee how much funding will be available for your trip. Traveler InformationName* First Last Todays Date* MM slash DD slash YYYY Email* Purpose of TravelPurpose of the trip* List the purpose of the trip. If this is a conference then put the name of the conference.Departure airport* Bradley International Airport Do you need a Bradley Parking Permit?* Yes No Destination* Is your trip international?* Yes No Departure Date* MM slash DD slash YYYY Return Date* MM slash DD slash YYYY Personal TravelIs there personal time on your trip?* Yes No Personal Time Start* MM slash DD slash YYYY Personal Time End* MM slash DD slash YYYY Travel FundingPlease indicate your travel funding for this trip* Department Funds AAUP/OVPR Travel Award Foundation Account Grant Account Host Institute Self Funded Other Was your AAUP/OVPR travel award sent to the finance department?* Yes No Select Yes if you put someone in the SSW Finance Department as your Admin Contact on the AAUP/OVPR Award ApplicationAAUP/OVPR Award Upload*Max. file size: 81 MB.Please upload your AAUP/OVPR Travel AwardPlease write the name of the grant* Please list the other funding sources* Estimated ExpensesIf an expense will NOT be reimbursed or direct billed please put 0Conference Registration Cost ($)* Airfare Cost ($)* Lodging Cost ($)* Meal Cost ($)* Mileage Cost ($)* Mileage rate is 0.545 per mileGround Transportation Cost ($)* Parking/Tolls Cost ($)* Miscellaneous/Other Cost ($)* Please Explain Misc/Other Exspenses*Direct BillingDo you need your registration direct billed?* Yes No If you need your registration direct billed contact Iris Strong or Carmen Feliciano-Ragland in the Finance OfficeSanditz BookingPlease check any expenses that were booked thru Sanditz* Airfare Hotel Car Rental Rail None Please upload your Sanditz itineraries* Drop files here or Select files Accepted file types: jpg, gif, png, pdf, html, msg, Max. file size: 100 MB, Max. files: 5. PhoneThis field is for validation purposes and should be left unchanged.