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Professional Meeting Request Form
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Name
Your answer
E-mail
Your answer
Department
Your answer
Date of Request
mm/dd/yyyy
Your answer
First -or- Second request of the current fiscal year?
First
Second
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Conference/Meeting Details
Conference Title or Meeting Name
Your answer
Do you have an official role at the conference or professional meeting?
Yes
No
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If NO, please explain reason for attending the conference.
Your answer
If YES, are you:
Select all that apply.
Presenting a paper
Chairing a panel
Representing a professional organization
Giving a performance or exhibition
Other:
Travel Details
Travel Location (Destination City/State)
Such as: Philadelphia, PA
Your answer
Travel Dates
mm/dd/yyyy - mm/dd/yyyy
Your answer
Registration Fee
Your answer
Estimated Travel Expenses
Please include ground transport, parking, airfare and/or mileage.
Your answer
Airfare or Auto?
Airfare
Auto
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If Airfare, list departing airport:
Your answer
If Airfare, Personal Automobile or Rental Car?
For airport transportation.
Personal Automobile
Rental Car
Clear selection
If Auto, Personal Automobile or Rental Car?
Personal Automobile
Rental Car
Clear selection
Estimated Lodging Expenses
Your answer
Estimated Meal Expenses
Your answer
Totals and Payment Method
Estimate of Total Expenses
Please include registration, travel, lodging and meal expenses.
Your answer
Payment Method
University Credit Card
Personal Payment
Both
Clear selection
Comments
Your answer
Submit
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