Professional Leave and Travel Request

(Assigned by Accounts Payable)

TR#:

PROFESSIONAL LEAVE AND TRAVEL REQUEST

This form must be approved for ALL individual travel that will be reimbursed by the College.

Traveler’s Name: / Conference/Event:
College-wide ID #: / Employees Traveling with you:
Title:
Department: / Destination (city/state):
Phone Number: / Departure Date:
Budget Code: / Return Date:
Purpose of Travel & Justification for Mode of Travel:
Estimated Expenses
See State of Louisiana Travel Guide for allowable expenses. / Special Circumstances:
Choose one: NO

YES. Authorization for Special Travel Circumstances (Form 1380/004)
is attached.
$ / Mileage® (estimated # miles @ 53¢/mile) / Routine Field Travel: Annual Certification of Employee Routine Field Travel Form
is required to reimburse for field travel under 30 mile radius of regular work domicile.
$ / Vehicle Rental for days ®®
$ / Lodging for days®® / CONFERENCE SCHEDULE/AGENDA MUST BE ATTACHED to show days/times of conference activities, meals provided, and conference hotel information.
Upon receipt of Accounts Payable Office email confirming travel approval, make hotel reservations following Delgado Travel Procedures.
For in-state travel, travelers should ask for the State Government Rate, bring a tax exempt form to avoid paying sales tax, and present the form to the hotel upon arrival.
$ / Meals for days

$ / Air Fare®® / Upon receipt of Accounts Payable Office email confirming travel approval, make flight reservations following Delgado Airfare Reservation Steps.

$ / Registration®®
(ATTACH Registration Form regardless of Payment Method) /
® Personal vehicle mileage is reimbursed at a rate set by the Office of State Travel.
Current rate is 53 cents per mile, maximum of 99 miles per round trip and/or day.
$ / Other Allowable Expenses / ®® Pre-Paid expenses: Lodging, Air Fare, Vehicle Rentals, and Registration/Dues are
pre-paid by the College.
$ / TOTAL Estimated Cost®®® /
®®® Sponsored Organization: Pursuant to L.R.S. 42:1123(41), a Complimentary Admission, Lodging, and/or Transportation Disclosure Statement (Form 413F) must be filed with the State’s Ethics Board within 60 days of acceptance if expenses are paid for by a civic, nonprofit, or educational organization, or a political group/organization.
$ / REQUESTED PRE-PAYMENT

Traveler’s Signature______Date____/____/____

I approve the professional leave and travel for this employee as described above, and I certify that I have determined these expenses to be the most cost beneficial method and mode of travel. I understand that the estimated expenses listed above may change when travel arrangements are finalized, and therefore, I hereby approve an additional $200 in estimated expenses in the event changes are necessary.

Dept. Head/Supervisor ______Date____/____/___

Appropriate Vice Chancellor ______Date____/___/____

Authorization to Travel/ Verification of Funds:

Assistant Vice Chancellor,

Financial Services ______Date____/____/___

Form 1380/001 (2/18)