THE ANNENBERG SCHOOL FOR COMMUNICATION
UNIVERSITY OF PENNSYLVANIA
FORM 9 TRAVEL & RESEARCH APPROVAL
You should complete this form and get an approval signature from your advisor and the Assistant Dean of Graduate Studies as soon as you know that you have had a competitively selected paper accepted at a convention/conference or have legitimate educational and research project expenses. You must submit this form to the Business Administrator no later than thirty (30) days prior to the expenditure.
Please attach (1) copy of your abstract and (2) a copy of your letter of acceptance OR the page from the conference program that lists your name and the title of your paper. For a legitimate educational and research purposes, please attach your project outline and anticipated budget.
Upon completion of your trip or project, please complete pages 2-3 of this form, attach the necessary receipts, and submit it to the Business Office within ten days. If you are unsure of the amount of money remaining in your travel & research budget for the year, please check with the Business Office.
Name of Student
Title of Paper or Project
Conference
Location of Conference
Date of Expense
Have you previously delivered a version of this paper at another conference? (Yes) (No)
If yes, please explain the additional value you anticipate from attending this conference______
Did the paper or project result from a class, independent study, other? (Please Specify)
Students traveling internationally must use the Global Activities Registry http://global.upenn.edu/gar Penn’s central resource for collecting information about the travel plans and activities of faculty, staff, and students preparing to travel abroad for academic, educational, clinical, research, or University business purposes. This secured information is used
· to contact travelers in emergencies
· to assist individuals and groups, as needed, with pre-travel preparations
· to identify opportunities for closer collaboration on international research and operations
Advisor (Print)______Advisor Approval Signature______Date______
Assist. Dean (Print)______Assist. Dean Approval Signature______Date______
Business Administrator (Print)______Business Administrator Signature ______Date______
THE ANNENBERG SCHOOL FOR COMMUNICATION
UNIVERSITY OF PENNSYLVANIA
If this form is approved and signed by the Business Administrator, reimbursement will be made for the lowest possible airfare, train fare, or mileage, and if student’s annual travel budget permits, for room and tax changes for hotel accommodation. No reimbursement will be made for meals and/or incidentals. Original receipts (see below), copies of the conference program, and a synopsis of the paper presented must be submitted to the Business Administrator within 10 days of the conclusion of the trip.
In order to be eligible for assistance with travel expenses, a student must be in good standing, enrolled for credit courses, and be receiving either financial support of a Dissertation Research Fellowship.
Insurance costs for rental cars will NOT be reimbursed, as they are covered under the University’s self-insurance plan. You must attend the University’s Drivers Safety Program to be eligible for this coverage. If you have not, the University will not be responsible should an accident occur, nor will the University reimburse you for the cost of insurance.
By signing below, I certify that the expenditures submitted were incurred by me while on official business in the city or cities indicated above. Further, this form certifies that I was insured for at least the statutory minimum for bodily injury and property damage for any automobile rental charges for which I seek reimbursement.
Total Value of Original Receipts $______
Please mount receipts on 8 ½ X 11 paper with clear tape. Please DO NOT use staples.
______
Signature of Student Date
UNIVERSITY OF PENNSYLVANIA
STATEMENT OF BUSINESS CONNECTION
This agreement dated this ____day of ______, 20_____ by and between the University of Pennsylvania, a not-for-profit institution of higher education organized under the laws of the Commonwealth of Pennsylvania having its principal address at 3451 Walnut Street, Philadelphia, Pennsylvania 19104 (hereinafter referred to as the University), and ______, whose address is ______, (hereinafter referred to as Student/Trainee).
RECITALS
The University desires to obtain representation from the Student/Trainee and the Student/Trainee has agreed to provide representation and has agreed to provide the representation on the terms and conditions set forth in this Agreement.
Now, therefore, in consideration of the faithful performance of the obligations set forth herein and other good and valuable consideration the receipt and sufficiency of which are hereby acknowledged, the University and the Student/Trainee hereby agree as follows:
1. Scope of Work. The Student/Trainee will promote the business objectives of the University and/or consult with and advise the University on matters and/or perform representation relating to the following (provide full detail of scope of assignment) ______.
2. Time Devoted to Assignment. In the performance of the Representation, the amount of time devoted by the Student/Trainee on any given day will be entirely within the Student/Trainee's control, and the University will rely on the Student/Trainee to put in such number of hours as are necessary to fulfill the requirements of this Agreement.
3. Reimbursement of Expenses. Student/Trainee shall be entitled to reimbursement from the University of certain approved out-of-pocket expenses in accordance with the accountable plan reimbursement policies of the University. In this regard, any approved expenses reimbursed by the University to Student/Trainee must be for a business purpose and must be adequately substantiated. Further, any excess reimbursements must be returned to the University in accordance with the University's accountable plan policy.
4. Term. The term of this Agreement shall commence on the date it is executed by the last to sign and shall continue through ______, 20___, unless terminated by either party for any reason.
5. Status of the Student/Trainee. The University and Student/Trainee intend that the relationship established between them pursuant to this Agreement shall be that of Professor/Trainer and Student/Trainee. The manner and means of conducting the assignment are under the sole control of the Student/Trainee. Student/Trainee will be solely and entirely responsible for his/her acts during the performance of this contract.
6. General. This Agreement shall be interpreted in accordance with the laws of the Commonwealth of Pennsylvania. This Agreement constitutes the entire agreement of the parties with respect to the matters addressed herein and no modifications of this Agreement shall be enforceable unless in writing signed by both the University and Student/Trainee.
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA STUDENT/TRAINEE
by:______by:______
(Business Administrator)
Last 4 digits of Social Security Number or Federal Tax Identification Number:
by:______
(Dean, Chairperson or Director)
(Rev. July 2008)