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.: __________________