EGH Travel Request Form Please note: You may save this form and continue later if you do not have all the materials ready. Make sure to click “Save and Continue Later” at the bottom of the page to the right of the “Next” button. Travel Request In accordance with the PHHP Professional Leave Policy travel-related purchases will NOT be processed until this form is received and approved by Grants Core or Department Personnel, and your PHHP TAR has been approved. Any purchases made prior to approval are made at the risk of the purchaser and reimbursement will not be guaranteed. To view the full EGH travel procedures, and additional resources, visit: http://egh.phhp.ufl.edu/resources/international-travel/. Please note that all travel request must be submitted 10 business days prior to travel start date. Step 1 of 2 50% Classification*Choose OneFacultyStudentStaffPostdocPI / SupervisorIf you are a faculty member, please choose your name below. If you are a student, postdoc, or staff please select the name of your advisor/supervisor. Ali, AfsarAnderson-Stark, HeatherBisesi, JosephBlue, AmyCoker, EricKane, AndyLednicky, JohnLiang, SongOkech, BernardMaurelli, AnthonyMcKune, SarahNelson, EricSabo-Attwood, TaraSergile, FlorenceWidmer, JocelynWood, ElizabethName*Please enter your name below First Last ApprovalPlease upload an email or other document to demonstrate that your advisor or supervisor approves of your travel/use of their funds Drop files here or Accepted file types: jpg, png, pdf, doc, docx. Departure Date* Return Date* Travel Location*Please indicate where you will be traveling below, include city, state, etc.)Will you receive funding from outside the University?*For instance, you are receiving an honorarium, or your expenses are being reimbursed by a conference that you are attending.YesNoFunding Source*Please provide the chartfield or name of the account your travel should be charged for below. If you do not know the account name or chartfield, please write the PI or Department who will be paying for your travel.Business/Academic Purpose:*If travel will be covered by a grant, how does this travel relate to the grant? If travel is covered by another funding source, please describe the purpose of your travel and it's benefit to UF File*Upload Conflict of Interest Form. The form can be found HERE. Please RIGHT-CLICK to open in a new tab. Accepted file types: jpg, png, pdf, doc, docx.Travel Type*DomesticInternationalInternational Travel Checklist*If you are travelling internationally, the International Checklist is required, to find the form, click here. Drop files here or Accepted file types: jpg, png, pdf, doc, docx. Team Assist/MedEx Card*Please attach your Team Assist/Med Ex card.. When registering your card, be sure to include even those dates that will be spent in-transit. To review the procedures required by the UF International Center, click here. Please RIGHT-CLICK to open in a new tab. Drop files here or Accepted file types: jpg, png, pdf, doc, docx. Do you plan to take personal vacation days as a part of your travel?*If you plan to take personal vacation days during your trip, or to extend your trip, please select Yes below.YesNoPlease indicate which days you will be taking personal time off*Leave Application*Please upload your completed leave slip here.Accepted file types: jpg, png, pdf, doc, docx.FileIf you are attending a conference, convention, or meeting that has a program or itinerary, please upload it here. If you would rather use a link, please copy paste the web address in the "Notes" section of this form. Otherwise you may skip this item.Accepted file types: jpg, png, pdf, doc, docx. Travel DetailsDaily Itinerary*Please provide a daily itinerary for your trip which includes dates, description of what you will be doing during your trip, and locations. Click the + sign to add additional rows. IF you have uploaded a conference program, you may simply state "Attend conference" as a description for the days that you will be in attendance. Click here for an example of what should be included in an itinerary. Please RIGHT-CLICK to open in a new tab. Date or Date RangeTimeDescription of ActivitiesLocation ExpensesBelow, please list all anticipated expenses for your travel. If you are unsure of an amount, make your best estimate. For Payment Method, please indicate how the expense will be paid using the keywords in the parentheses: personal funds (PERSONAL), UF pcard (PCARD), complimentary/outside UF source (COMP) Click the + sign to add more expense lines. Click here for an example.Airfare*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) Lodging*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) Rental Car*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) Baggage*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) Taxi/Bus/Shuttle*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) Meals Per Diem*If this expense is not applicable, write N/A in the Expense Box and then proceed. For domestic travel all travelers will be awarded a maximum of $36/day ($6/breakfast, $11/lunch, $19/dinner).Estimated number of days for which meals are needed: Meals Per Diem*If this expense is not applicable, write N/A in the Expense Box and then proceed. For international travel, per diem rates vary by both country and city. We will calculate an estimate based on your answers below. If you are visiting more than one city please click the + sign to the right of the boxes to add another row.Location (City, Country):# of days for which meals are needed Other (Click the plus sign to add more rows)*If this expense is not applicable, write N/A in the Expense Box and then proceed.Description of ExpenseEstimated CostPayment Method (Personal Funds, UF Pcard, Cash Advance)Purchaser (Self or Name of Department) FileIn the absence of extenuating circumstances, all pre-travel purchases (flight, hotel, car rental, etc.) should be made with a UF Pcard. In the event that any travel-related purchases have been made prior to submission of this form, please upload your purchase confirmations here. Drop files here or NotesIf there is any additional information you think we may need about your trip, or questions that you may have, please write them in below. Alise will respond to your questions as soon as possible.