CMLT Department Pre-Travel Form

Please fill out and submit this form at least two weeks prior to travel.

Trip Information
Traveler Name *
Destination *
Departure Date / MM / DD YYYY
Return Date / MM / DD YYYY
Purpose of Travel Please provide a 1-2 sentence statement about how this travel will relate to your work at IU. If you are attending a conference, please include its full name without acronyms.

Please provide a 1-2 sentence statement about how this travel will relate to your work at IU. If you are attending a conference, please include its full name without acronyms.
Will this trip included personal time? Yes No
Which days will be personal time? Note: Personal time can be taken at the beginning or end of a trip, not both

Note: Personal time can be taken at the beginning or end of a trip, not both
Which account will be used for this trip's costs? Account number not needed, "my research account" is fine

Account number not needed, "my research account" is fine
Means of Travel
Air Personal Vehicle Other
Departure Airport
Destination Airport
How will the flights be booked I will book myself and request reimbursement I will book myself using IU funds on Egencia Please book air travel for me
Estimated Airfare $ . Dollars Cents
Please list any preferences or instructions you have for the booking of air travel
Departure Address (This will be used to calculate mileage reimbursement)
Street address Address line 2 City State/Province/Region Postal/Zip code Country
(This will be used to calculate mileage reimbursement)
Destination Address (This will be used to calculate mileage reimbursement)
Street address Address line 2 City State/Province/Region Postal/Zip code Country
(This will be used to calculate mileage reimbursement)
Please describe your other means of travel
Estimated cost of travel $ . Dollars Cents
Lodging
Where will you be staying? Hotel/Airbnb No Cost Lodging (Staying with friend/family/colleague) Other
How will the lodging be booked? I will book myself and request reimbursement I will book myself using IU funds on Egencia Please book lodging for me

Note: I cannot book reserved conference rooms or book at conference rates on your behalf.
Estimated total cost of hotel/Airbnb $ . Dollars Cents
Please list any preference you wish to be considered when booking lodging.
Other (Please describe)
Estimated cost of lodging $ . Dollars Cents
Per Diem
Do you wish to claim per diem? Yes No
Please list the location that should be used for the per diem calculation. Include dates for each location if there is more than one. This should be the location of your lodging, not the location of a conference. For U.S. travel, you just need to list the zip code. For international travel, list the city and country.

This should be the location of your lodging, not the location of a conference. For U.S. travel, you just need to list the zip code. For international travel, list the city and country.
Please list any meals that are already included in other costs. Examples: Breakfasts provided by the hotel or lunch provided by a conference

Examples: Breakfasts provided by the hotel or lunch provided by a conference
Other Costs

Please list any other estimated costs that you anticipate requesting reimbursement for. Examples: airport shuttle, airport parking, airline baggage fees, conference registration fee, taxi/uber/lyft fares, etc.
Expense
Estimated Cost $ . Dollars Cents
Expense
Estimated Cost $ . Dollars Cents
Expense
Estimated Cost $ . Dollars Cents
Expense
Estimated Cost $ . Dollars Cents
Expense
Estimated Cost $ . Dollars Cents
Notes and Attachments
If there is any additional information about your travel that you wish to provide, you may enter it here
If there are any files you wish to submit, you may do so here

Attach Files

CMLT Department Pre-Travel Form

CMLT Department Pre-Travel Form

Trip Information

Means of Travel

Lodging

Per Diem

Other Costs

Notes and Attachments