School of Nursing - Authorization for Travel
To request a University vehicle, fill out the Vehicle Request Form.

If you will have students accompanying, on trip you must fill out the Student Travel Notice and turn into CN 418.

If you are making a multi-leg trip, please submit multiple forms, one for each leg of the trip. Thank you.

For reoccurring trips (e.g. clinicals) use your first day of travel as your 'Leave Date' and your last day of travel as your 'Return Date' and provide specific dates of travel in the comments section.

Items with an * indicate a required field.
First Name *
Last Name *
Purpose of Trip *
Destination City & State *
Destination Zip
Full Name of Conference
Leaving From City & State *
Leaving From Zip
Leave Date *    
Leave Time *
Specify exact time, e.g. 8:00 AM
Arrive Date *    
Arrive Time *
Specify exact time, e.g. 8:00 AM
Returning To City & State *
Returning To Zip
Departing Date *    
Return Date *    
Departing Time *
Specify exact time, e.g. 8:00 AM
Return Time *
Specify exact time, e.g. 8:00 AM

Please select all that apply.
  I have been pre-approved for SoN funding (must have documentation).
Approved Amount
  I plan to request travel fund from College of Health (not for clinicals).
Download College of Health Travel Fund AY 2015
  I have grant funds available for travel.
Grant Name, Number, or Fund Number
If requesting mileage reimbursement, input your round-trip mileage here.
Additional Information / Comments
Acknowledgement *  I understand that my authorization for clinical travel and/or off-site instruction will be rejected if my health clearance documentation is not 100% current with the School of Nursing.
Course Coverage
This trip will result in a variation from my normal teaching (didactic or clinical) schedule including, but not limited to, missed, rescheduled, or substitute-lead clinical or lecture sessions. *  Yes
If you answered yes to the above question, you must complete the submit the Class Coverage Form to be approved for travel.

Download Class Coverage Form