Request for Campus Absence * NAME: First Last * ABSENCE CATEGORY: Choose One University Travel Consulting Personal * UIN: * NetID: * PHONE NUMBER: * DESCRIPTION OF ABSENCE/PURPOSE OF TRAVEL: Meeting / Workshop / Conference, etc. Please provide a detailed description of your upcoming travel, i.e., conference name, workshop, paper or poster presentation, meeting, etc. BE SPECIFIC! CONFERENCE PAPER or POSTER TITLE/NUMBER: If you are presenting a paper or poster, please provide the TITLE/NUMBER here. * DESTINATION (City, State, Country): * DATE FROM: * DATE TO: * EXPENSES WILL BE REIMBURSED BY THE UNIVERSITY: YES NO * TOTAL ESTIMATED COST TO UNIVERSITY: The costs include CONFERENCE REGISTRATION, TRANSPORTATION (airfare, bus, train, car rental, personal car mileage), LODGING, PER DIEM, etc. * ACCOUNT NUMBER: Provide the account number or name of the account that will fund your travel. TCARD/PCARD PURCHASE: Registration Airfare Lodging Bus Train If you need registration, airfare, bus, train and lodging paid with a department card, please specify here. IEEE MEMBER NUMBER: Please provide your IEEE Member Number here, if you need registration paid for an IEEE conference. If it requires a secure login, please provide "User Name" and "Password" in the "NOTES" section at the bottom of this page. AADVANTAGE NUMBER: American Airlines Miles Program Number CONFERENCE FOOD PREFERENCE: None Vegetarian Vegan Dairy Free Gluten Free Other (specify in notes) Please provide this information if you require conference registration. CLASS INFORMATION 1 - (For Instructors Only): Course & Section / Day & Time/ Arrangements CLASS INFORMATION 2 - (For Instructors Only): Course & Section / Day & Time/ Arrangements CLASS INFORMATION 3 - (For Instructors Only): Course & Section / Day & Time/ Arrangements NOTES: