HPELS Faculty Travel Request- Estimated Expenses Form 2015-2016 NAME: DATE: NAME OF CONFERENCE: DATES OF TRAVEL: CONFERENCE LOCATION: Do you plan on presenting? YES NO If yes: Please include the following information- (a) Date of abstract submission, (b) Estimated timeframe for abstract acceptance, (c) Type of presentation requested, (d) Are students co-presenting or co-authors?, (e) Will you still attend if your work is not accepted?, (f) Are you seeking any other outside funding/assistance for travel? ESTIMATED EXPENSES (please include best estimations for all applicable): Conference Fees Hotel Accommodations Airline tickets Mileage (Roundtrip miles x .28/mile) Per Diem ($8 b’fast; $12 lunch; $20 dinner) Total Expenses: *Please submit completed forms to Dr. Corbett NO LATER THAN OCTOBER 1, 2015. **Student travel requests will also be considered- please complete a separate form for your students. All students attending the same conference may be listed on the same request.