Travel and Expenses Request Form

Department of Radiation Oncology REIMBURSEMENT: To insure prompt processing of travel reimbursement, all pertinent data and receipts must be forwarded to the Fiscal Section within five (5) working days of the employee's return. Please be advised that it is to your advantage to retain ANY and ALL receipts, which reflect funds expended while on your trip. PLEASE NOTE: WHILE YOU CAN and SHOULD SUBMIT THIS FORM ONLINE ALL NECESSARY SIGNATURES ARE STILL NEEDED, PLEASE PRINT COMPLETED FORM AND ROUTE THROUGH PROPER CHANNELS FOR APPROPRIATE SIGNATURES.

Name*
First Last
Email*
UF ID*
Type of Travel*
Destination*

City, State, and Country (if foreign travel)
Purpose of Travel*
- Annual Meeting
- Presentation
- Moderator
- Conference Attendee
- Other (explain below)
If other, explain below.
Funding Source*
Name of Grant or Funding Agency
Is payment for registration needed?*
- Yes
- No
Departure Date*
MM slash DD slash YYYY
Return Date*
MM slash DD slash YYYY
Number of Days*
Departure Airport
Destination Airport
Estimated Costs
Cost of Airfare
Hotel Cost (per night)
Total Nights in Hotel
Meals - Breakfast Quantity
Price: $6.00
Meals - Lunch Quantity
Price: $11.00
Meals - Dinner Quantity
Price: $19.00
Registration Cost
Rental Care Cost
Mileage Quantity
Price: $0.44
Miscellaneous Expenses

Any unusual extra expense due to changes in reservations may have to be borne by the traveler. Always coordinate reservations/changes with your secretary or the fiscal office.
Total
$0.00
Approvals
Duties will be covered by
Traveler's Signature
Approved by

Program Director/Chief
Approved by

Department Administrator
Approved by

Department Chair
Fiscal Section

Funding Allocation
Account Number

Estimated Costs

Approvals

U.S. News and World Report

Annual Research Seminar

UF Health Cancer Center