UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT PEORIA
STUDENT TRAVEL RESOURCES
University of IllinoisCollege of Medicine at Peoria Student Affairs/Budget Advisory Committee
Student Travel Financial Support Application
Name: ______Date: ______
UIN ______EMAIL ______
Date(s) of TRAVEL ______
Location (city & state) ______
Title of Meeting or Event ______
Purpose of Travel ______
If presenting a poster, paper, workshop, etc., provide FULL TITLE and names of co-presenters: ______
______
AnticipatedExpenses:Estimate all expenses associated with your travel, including airfare, hotel, registration fees, meals, etc.
Description of Expense / Date(s) / AmountTOTAL Anticipated Expenses
Anticipated Additional Funding: List all other anticipated sources of income (outside BAC) for the travel described above. Indicate whether the amounts have been requested or have been approved.
Source of Funding / Requested / Approved / AmountTOTAL Funding Anticipated from Other Sources
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ADDITIONAL COMMENTS OR EXPLANATIONS:
Instructions: Submit the 2 pages of the completed form to Student Affairs Office a MINIMUM of FIVE weeks in advance of travel. IF MULTIPLE STUDENTS ARE TRAVELING, ALL STUDENTS SHOULD SUBMIT INDIVIDUAL REQUESTS, ITEMIZING THEIR INDIVIDUAL EXPENSES
NOTE WELL: Advance purchases or reservations should not be made independently by the student without prior approval from Student Affairs. Travel arrangements that do not conform to state and university policies will not be reimbursed. If travel is cancelled or you do not need the funds, notify Student Affairs immediately so that funds can be released.
HOW TO GET REIMBURSED: Requests for travel grants are approved monthly at the BAC meeting. Students will be notified of approval shortly after the meeting. A travel grant represents a promise of reimbursement upon submission of an itemized statement of expenses and receipts. Reimbursements are paid through UIC Student Accounts. To be reimbursed, students must itemize expenses according to the attached guide and submit the itemization to Student Affairs within 30 (thirty) days following conclusion of travel.
Call 309-671-8411 or contact the Student Affairs Office Manager with questions.
DETACH and retain the reimbursement form on the next page for use at conclusion of travel.
University of Illinois College of Medicine at Peoria
Student Affairs/BAC Student Travel Reimbursement Documentation
Instructions: Regardless of the amount of your travel ‘grant,’ fill in expenses for all categories – if $0, give a brief explanation of why there was no charge. An incomplete form may result in delay or denial of reimbursement. Attach copies of paid receipts (zero balance due) for everything except food. Note that prohibited expenses include rental car charges (submit miles driven between home and conference location instead), membership fees, travel between home/work and the departure/origin airport; incidental transportation in the conference city; alcohol; expenses paid on behalf of others. Turn this form and documentation in to Student Affairs within 30 days after conclusion of travel.
TRAVELER INFORMATION
LAST NAME:
FIRST NAME:
Email Address:
UIN (VERY IMPORTANT):
REASON FOR TRAVEL/NAME OF CONFERENCE or MEETING:
DATES of TRAVEL: From MM/DD/YY TO MM/DD/YY
LOCATION OF CONFERENCE OR MEETING (City):
ITEMIZED EXPENSES
REGISTRATION FEE: $
LODGING
Name of Hotel (if not the designated “conference hotel,” explain):
Nights stayed:
Total Paid for Lodging only: $
TRANSPORTATION to/from CONFERENCE
RT Air, Train, or bus fare between Peoria and Conference Location: $
OR
RT Mileage driven (personal or rental vehicle) between Peoria and Conference Location: miles
Parking fees at Conference Location: $
GROUND TRANSPORT at CONFERENCE CITY
Transport from Airport/Train Station to Conference Site on arrival day: $
Transport from Conference sit to Airport/Train Station on departure day: $
MEAL EXPENSES (do not include alcohol, snacks, or meals purchased “at home” in Peoria, or meals that were included in the cost of the conference registration): $