Travel Information Form Travel Information Form Choose One* I am the traveler I am submitting this travel request on behalf of the traveler Submitter InformationName of Submitter* First Last Email of Submitter* Traveler InformationName of Traveler* First Last UFID*Traveler's Email* Traveler's Department*Note – students should indicate which department their PI/funding source is associated with.Select OneBiostatisticsClinical Health PsychologyCollege AdministrationEnvironmental Global HealthEpidemiologyHealth Services Research, Management & PolicyOccupational TherapyPhysical TherapySpeech, Language, & Hearing SciencesTrip InformationReason for Travel*Destination, description of meeting, conference, etc.Business Purpose*Describe how this trip benefits the University.Is this trip being combined with personal leave (before or after the start of the business travel)?* No Yes – Before Yes – After Yes – Before & After Departure Location* City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Destination Location* City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Departure Date* MM slash DD slash YYYY Departure Time (approximate)* : Hours Minutes AM PM AM/PM Start Date of Professional Travel*Since you combined this trip with personal leave, please enter the date that your professional leave begins. MM slash DD slash YYYY Professional Travel Time*Since you combined this trip with personal leave, please enter the approximate time that your professional leave begins. : Hours Minutes AM PM AM/PM Start Date of Personal Travel*Since you combined this trip with personal leave, please enter the date that your personal leave begins. MM slash DD slash YYYY Personal Travel Time*Since you combined this trip with personal leave, please enter the approximate time that your personal leave begins. : Hours Minutes AM PM AM/PM Return Date* MM slash DD slash YYYY Return Time (approximate)* : Hours Minutes AM PM AM/PM Are you taking any UF equipment (including UF laptop) with you while you travel?* Yes No List the equipment traveling with you and include the UF property decal or serial number.*Description of EquipmentDecal/Serial Number Conference/Travel Program*Upload a copy of the conference program (official program preferred, unofficial accepted), announcement, email correspondence, invitation, or other documentation that outlines the trip.Max. file size: 10 MB. Funding Source(s)Funding Source(s)*Please choose all that apply: Grant or Project (sponsored research) T32 Training Grant Other UF Funds (startup, IDC, professional funds) Department funds (*Your department may request that you upload documentation of approval to use these funds) Personal Funds Reimbursed or covered by non-UF entity Description of Funds*Use the space below to describe which accounts you will use. If expenses should be split, describe the approximate split.Examples include: ”[PI Name] R01” ”Split travel between [PI name] DoD award and Florida Health award.” ”Charge $400 to my NMPT travel award, the rest will be paid from [PI’s name] R01.” ”The host will be paying for my travel, no funding needed.” ”Use up my professional development funds, then put the remaining on my IDC account.” ”This trip will be covered by the department, see attached approval from the Department Chair.” ”Use up my professional development funds, I will cover the remaining costs with personal funds.” Is the Traveler the PI of this award?* Yes No PI Name* First Last PI Email* PI Approval for use of grant funds*Upload a copy of the email where the PI approved the use of grant funds (including estimated amount) for this trip.Max. file size: 10 MB. Approval for use of department fundsUpload documentation of approval to use department funds if available. This may be an email exchange between you and the Department Chair, communications from the department staff, etc. (Note: Some departments may require this – look out for communications from your department regarding their specific requirements)Max. file size: 10 MB. Estimated ExpensesChoose all anticipated pre-paid expenses* Airfare Car Rental Registration Fees Lodging Not Applicable – no pre-paid expenses are anticipated Choose all anticipated expenses for reimbursement* Gas Mileage (private vehicle only) Meal Reimbursement Taxi/Shuttle/Ride Share Parking Miscellaneous (Tolls, baggage, etc.) Not Applicable – No additional expenses are anticipated AirfareEnter Airfare notesEstimated Cost of Airfare*Flight DetailsPreferences for airline, time, departure/arrival airport, frequent flyer number or known traveler ID, if applicableOptional: Upload PDF of preferred flight itineraryMax. file size: 10 MB. Car RentalNote – car rentals are limited to the state contract with AVIS/Budget and should be booked through the department. Please keep this in mind when listing preferred pickup/drop off locations.Estimated Cost of Car Rental*Optional: Name of Individual(s) splitting costsPreferred Pickup Location*Pick Up Date* MM slash DD slash YYYY Pick Up Time* : Hours Minutes AM PM AM/PM Preferred Drop Off Location*Drop Off Date* MM slash DD slash YYYY Drop Off Time* : Hours Minutes AM PM AM/PM RegistrationEstimated Cost of Registration Fees*LodgingEstimated Cost of Lodging*Optional: Name of Individual(s) splitting costsLodging DetailsPreferred location, conference booking code, room type (king, 2 queen), etc.Alternate Lodging Option(s)Please include an alternate lodging choice, in case preferred choice is not available.Optional: Upload PDF of preferred lodgingMax. file size: 10 MB. Meal ReimbursementsMeal Reimbursements*Meals are reimbursed using the state (domestic) and federal (international) rates, calculated based on the date and time that your trip begins and ends. There is no need to keep receipts for meals. Please be aware that any meals included in conference registration, whether you participate or not, are not eligible for reimbursement. I understand that meal reimbursements will be calculated using the appropriate rate and that meals offered by the conference, whether I attend or not, are not eligible for reimbursement. GasEstimated Cost of Gas*Note – gas receipts are required for reimbursement.Mileage ReimbursementMileage (private vehicle only)*Mileage is reimbursed using the state rate, calculated based on the most direct driving route between your home address and the address of your destination. UFGO will automatically calculate these amounts. I understand that mileage reimbursements will be automatically calculated using the appropriate rate. Taxi/Shuttle/Ride ShareNote – Receipts for taxis/shuttles/ride share (Lyft, Uber, etc.) are required for trips over $25. The receipt must include the date, time, start/end addresses and a breakdown of costs. Tips are limited to 15% of the pre-tax amount.Estimated Cost of Taxi/Shuttle/Ride Share*Optional: Name of Individual(s) splitting costsParkingEstimated Cost of Parking*Note – Receipts are required to reimburse parking.MiscellaneousEstimated Cost of Miscellaneous*Tolls, baggage, etc.Description of Miscellaneous Expenses*HonorariumsAre you receiving any type of honorarium associated with this travel?Select OneNoYesTravel Reimbursement/Waived Registration OnlyPlease let us know if your honorarium is a significant amount. Otherwise, no Conflict of Interest disclosure is required and you are not required to use personal leave.No disclosures or use of personal leave are required when your travel and/or registration is being covered.Additional InformationPlease note any other details necessary to book your travelOptional uploadsMax. file size: 10 MB.
