University of Michigan – Flint
School of Education and Human Services
Travel / Hosting Pre-Authorization Form 2015
ALL travel and hosting must have pre-approval from the SEHS Dean’s Office. The Dean’s
Office will not accept pre-authorization forms submitted after an event or trip. All sections
of this form must be completed before submitting to the Dean’s Office or the form will be
returned to you – unsigned and unapproved.
Traveler / Host’s
Name & Title
Traveler/Host’s Signature & Date: _____________________________________
Department:
Business Purpose of Trip or Event:
Date(s) of Trip or Event:
Estimated Costs of the Trip or Event:
Note: If this is hosting, please include per person cost & caterer information
Name of Account AND Account Number:
Current Account Balance:________________________________________________
Designated Funds or General Funds?
Chairperson/Director’s Name:
Chairperson/Director’s Signature & Date:
_______________________________________________________________________
Signature of Budget Analyst & Date: _______________________________________
Executive Officer (or Delegate’s) Name: Dr. Robert Barnett, SEHS Dean
Executive Officer (or Delegate’s) Signature & Date:_______________________