NAME _____________________
Total Request ________________
____ First Meeting; ____ Additional Meeting

1. Statement of plans
Meeting _______________________________________
Dates ________________________________________
Location _______________________________________
Check:
a) _____ attendance
b) _____ participant; _____ paper; _____ panelist;
_____ by application; _____ by invitation
c) _____ other - specify:

2. Breakdown of estimated expenses:
a) Conference registration fee: $________________ *
(Membership dues are not covered by faculty travel)
b) Transportation cost: air $_______; ground $________ ***
c) Lodging: _____ nights at hotel at $________ per night ** Total lodging: _______
d) Meals: $________ Please keep all original, itemized receipts. If a receipt is for more than one person, indicate your portion. Meals can be reimbursed up to $55 per day.

* Payment of registration fees must be documented for reimbursement.

** Hotel costs will be reimbursed at the published convention rates for the number of nights for the scheduled meeting plus one travel schedule night when necessary. A copy of the hotel bill is needed for reimbursement. Please share a room when possible.

*** Travel in personal cars will be reimbursed at $.55 per mile. We now have three options for getting to the Des Moines and Cedar Rapids airport:

A. A faculty or staff member can drive their own car and park in airport parking. The College will reimburse them for the round trip mileage at the standard rate of $.55 and for airport parking.

B. A faculty or staff member can arrange for a car to be reserved from Enterprise, pick up the car at the Campus Security Office and drop it off at the airport terminal (Faculty academic support assistants will make these arrangements as requested by faculty members.). Upon return, a car can be picked up at the airport and returned to the Campus Security Office. There will be no charge to the faculty or staff member for this service.

C. A faculty or staff member can arrange for a driver to pick them up and deliver them to the airport and then pick them up at the airport upon return. The cost of this service includes mileage and the labor cost of the driver and is typically in the $65-90 range each way. The faculty and staff member will personally pay all costs in excess of $66.00 each way. If the faculty or staff member has a family member of friend drop them off and/or pick them up from the airport, they will be reimbursed for mileage of the round trips to the Des Moines or Cedar Rapids Airport.

Return this completed form to the Dean's Office, Nollen House 2, by November 1 for "first meeting" requests and the following dates for additional meeting requests, Sep 15, Nov 15, Feb 15, or May 1. Submit the completed Travel Expense Voucher form with all original, itemized receipts to the same office within 30 days of your return.