WESTERN ILLINOIS UNIVERSITY Travel Request New – Star # 35467 Change – Star # Travel Arrangement Form For faculty travel to Macomb, QC, and Extension sites for regularly scheduled classes. Contact Elaine Squier with travel questions: 309/298-2108. If travel form is not completed, no arrangements nor funding will be provided to travel. (Sections A & B to be filled out) A. Term Fall Spring Minimester Summer Year: 2010 B. CLASS SCHEDULE INFORMATION Department /Course #: Eng 400 Course Start Time: 8:00 am Course End Time: 5:00 pm Please list all dates of travel: Tues., 8/24, 31; 9/1, 8, 15, 22, 29; 10/6, 13, 20, 27; 11/3, 10, 17; 12/1, 8, 15 C. ORIGINATION Macomb WIUQC Other: D. DESTINATION WIUQC Macomb Extension Site Name: *Explain if “Other” is checked: E. VEHICLE State Auto *Personal Auto Mini-van No Vehicle Needed *Personal auto requires written rationale and approval by Department Chair and Director of the School of Distance Learning, International Studies, and Outreach. F. OTHER TRANSPORT ACCOMMODATIONS Travel is scheduled to originate at the faculty member’s home campus with return of the State auto to that same campus. Travel pools are organized when two or more courses meet at the same site and have similar time frames within one hour of each other. It other commitments exist which would prevent a faculty member from this flexibility, please describe. If you need an accommodation related to a medical condition, please contact the Affirmative Action/ADA Compliance Office to discuss arrangements. G. LODGING Faculty members will receive prior approval for overnight stays and will make their own arrangements. Please refer to the travel guidelines for maximum reimbursement allowed. Those not receiving prior approval will not be reimbursed. SIGNATURES Faculty Member: ________________________________________ Department Chairperson: _________________________________________ Date: _______________ Date: _______________ * All travel requests can be submitted directly to Elaine Squier, Horrabin Hall 10 07/21/10