ACM_travel_authorization_form
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Volunteer Travel Request, Authorization and Approval Form
Part A - Travel Request
(To be completed by person requesting travel support)
1. Name: ________________________________________________________________
Address: _____________________________________________________________
______________________________________________________________________
Business Phone ____/____-_____ Home Phone: ____/____-_____
E-mail Address ______________________________________________________
Social Security Number or National Taxpayer Number __________________
2. ACM Position: ________________________________________________
Purpose of Travel: ___________________________________________
3. Date(s) & Destination(s):
From: _________________ to ________________ on ______________
and to ________________ on ________________ and to __________
on ___________________ and to _______________ on ______________
4. Estimate of Support Needed: 5. ACM Sub-Unit to be Charged:
Name $ Amount or %
Transportation $ _________ __________________________________
Subsistence $ _________ __________________________________
Other $ _________ __________________________________
Total $ _________ __________________________________
6. Advance (if any) Required: $ ______________
7. Signature of Requestor: ___________________________ Date: ___________
Part B - Authorization(s)
(To be completed by volunteer approval authority)
1. Signature __________________________________________________________
Date ___________________
Position _______________
2. Signature __________________________________________________________
Date ___________________
Position _______________
3. Signature __________________________________________________________
Date ___________________
Position _______________
If any changes to the request are being made, indicate them here and
initial them: ___________________________________________________________
_________________________________________________________________________
All signators verify that these funds have been budgeted and are
available to the requestor.
Part C - Approval
(To be completed by ACM Headquarters)
Cost Center # $ Amount or % Controller's Approval: _________________
___________ _____________ Date: ___/___/___/
P.O. No.: __________________