WESTERN ILLINOIS UNIVERSITY
Travel Request
New – Star #
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:
B. CLASS SCHEDULE INFORMATION
Department /Course #:
Course Start Time:
Course End Time:
Please list all dates of travel:
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