Travel Reimbursement Worksheet

This form is used for reimbursement of any travel for those who have an approved Application for Travel completed prior to travel.

After traveling, info and receipts are needed to prepare the Travel Voucher to reimburse your expenses. AFTER SUBMITTING this form, all receipts and conference booklet should be submitted at one time. (The conference booklet will be returned to you.)

NEW UNIVERSITY RULE: if a university credit card paid for any portion of your trip, a travel voucher is required whether you are due a refund/reimbursement or not.

Name Name * First Last
Traveler's Name
EIU Email Address *
I am a... *

I am a... Faculty or Staff Graduate Student Undergraduate Student Other Other
What is your Home Address What is your Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Do you receive a regularly scheduled paycheck from the university or are you serving as a student tutor? *

Do you receive a regularly scheduled paycheck from the university or are you serving as a student tutor? Yes No
Names of all others who traveled with you on this trip. *
Conference Name (If not a confrence indicate 'None'.) *

Name of conference attended (no abbreviations) -- Please provide the conference booklet. It will be returned to you.
Conference Date or Travel Dates *

Date(s) conference was in session
City and State (Destination) *

City and state where conference was held. If not attending a conference but field work is being performed, indicate nearest city/state.
Title of presentation or reason for travel *
Was a PCard used for any part of this trip? *

Was a university PCard used for any of your travel expenses (do not include registration fee)?
Detail how this trip will be paid. Please include account numbers and grant/award names. *

What pool of monies will be used to reimburse you? Tiffany Grant? Start Up Funds?

Please include the ORG or Account number, if applicable.
Were any meals provided?
What time did you depart Charleston? *

Date and time (AM/PM) traveler DEPARTED from Charleston
What time did you return to Charleston? *

Date and time (AM/PM) traveler RETURNED to Charleston
Personal Time *

Does any of the travel time include personal time or vacation time? If so, please explain. If does not apply, indicate 'NONE'.
Vehicle Used? *

If flight was involved, how did you get to the airport or train station?
Who was the driver?
Mileage

If personal vehicle, indicate total/round trip mileage or odometer readings
Upload a File for Vehicle Expenses

Attach Files

Vehicle Expenses: parking? highway tolls? (provide receipts). If you did not have any, skip this item.
Upload Airfare Files

Attach Files

Airfare: provide airline receipt with pricing and flying dates and time, plus any luggage receipts. If you did not fly, skip this item.
Lodging Information *

Hotel Information: Be sure that your receipts have the city, state, phone number and dates. Provide a detailed receipt with pricing.

If a hotel room was shared, who stayed in the room?

If doesn't apply: indicate 'none'
Hotel Receipt Upload

Attach Files
Was this a conference hotel? *

Was this a conference hotel? Yes No N/A
Did you take a Shuttle or Taxi during your trip? If so, upload reciepts.

Attach Files

Shuttle to/from airport and hotel. Provide shuttle receipts.
Use this to upload any additional files that may be needed.

Attach Files
How would you like to receive your reimbursement?

Please indicate how you would like to be paid for this trip. Students who are not employees may not choose direct deposit.
Type the letters you see in the image below.