Request for In-State Travel

Name
Current Date
Event
Date(s) of Event
Location (city/state)
Your e-mail address
I am seeking time off from work and/or funding to attend the event noted above. It is in the interest of Information Resources that I attend because:
Projected cost (accuracy is essential!)
Transportation	Cost
State vehicle	$
Private vehicle	$
Misc. costs (parking, tolls)	$
Registration	$
indicate if meals are included w/fee.
Lodging	$
Meals (applicable only if overnight stay included)	$
Grand Total	$
Please Choose One:
Request funding and time off
Request time off only
I have discussed this request with my Unit Manager: Yes No Please forward any descriptive literature and registration forms you may have regarding your trip to Peggy Dollard.