Travel Form 2627.xlsx

	A	B	C	D	E	F	H	I	K	L	M	N	O	Q
1
2				ENGLEWOOD SCHOOLS TRAVEL PER DIEM & MILEAGE FORM
3
4
5
6
7	Employee Name:
8	Conference Name:
9	Conference Date:
10	PO Number:
11
12		Mileage					Other		Meal Per Diem
13	Travel Dates	Starting Location	Ending Location	Mileage	Year 2026 Mileage Reimb Rate	Total Mileage Reimbursement	Parking	Ground Transportation (Taxi, Shuttle, Uber, etc)	Breakfast	Lunch	Dinner	Incidentals	Total Meal Per Diem	Total Reimb
14				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
15				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
16				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
17				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
18				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
19				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
20				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
21				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
22				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
23				-	$ 0.725	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
24						$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -	$ -
25
26
27	Note:	The following documents must be submitted with the approved Travel Form.
28	1)	Agenda or Itenerary of conference including Dates & Times
29	2)	Google Map from Work location to Conference location
30	3)	Reciepts for Parking and Ground Transportation after travels
31	4)	Printout of GSA rates page where travel is taking place (https://www.gsa.gov/travel/plan-book/per-diem-rates)
32
33
34
35
36
37
38		Employee Name			Employee Signature				Date
39
40
41
42		Approver's Name			Approver's Signature				Date				Revised 7/26/2026.
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100