Valdosta State University
Request for Authority to Travel

** THIS REQUEST FOR AUTHORITY TO TRAVEL MUST BE COMPLETED AND ALL APPROVALS OBTAINED BEFORE YOU ACTUALLY TRAVEL. **

* Denotes required field.
*Select: *Applicant:
*ID# (Last 4 Only): *Employing Dept/Unit:
*Dept Contact: *Ext:
TRAVEL DATA
*Purpose:
*Destination:
*Individual responsible for day-to-day operations in your absence:
*Dates of Travel: (From) (To)
*Work Phone #: Travel Phone #:
*Email:
ESTIMATED COSTS (Do not include prepaid expenses in estimated costs. If any item is prepaid, submit on Prepaid Form.)
1. Transportation Cost: Air
Personal Car
Other
Total $
2. Automobile Rental: $
3. Registration Fees: $
4. Hotel and Meals: Hotel
Meals
Total $
5. Other: (Taxi, Parking, Phone) $
Total Estimated Cost (To Be Paid As Outlined Below) $
REIMBURSABLE COSTS (*At least one is required.)
The following account numbers are to be used for reimbursement, if expenses are shared by different budget units, list each number and the amount each will pay:
1. $
2. $
3. $
4. $
Total Reimbursable Cost $
(Should Equal Total Estimated Cost Unless Reimbursement Is Limited)
*E-mail address of approver of reimbursable costs - Line 1 :
*E-mail address of approver of reimbursable costs - Line 2 :
*E-mail address of approver of reimbursable costs - Line 3 :
*E-mail address of approver of reimbursable costs - Line 4 :
*I attest that the above travel plans will comply with USG Travel Regulations:
*Have you viewed the motor vehicle use video:
*Have you completed the drivers acknowledgement form:
*I am aware that failure to submit flight details will result in non-reimbursement for airfare:

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