---

Authorization for Out-of-State Travel

---

Applicant		Title		Date
Email
I am requesting travel authorization for the inclusive dates, destination and purpose indicated:

Travel Dates
Leave	Return	Conference Dates		City	State	Country
(Travel dates must correspond with dates on travel reimbursement)
Check here if you will be gone for more than 30 days.
Purpose

Total Estimated Expenses: Transportation $ Lodging $ Meals $ Registration Fees $ Other $ Grand Total $				Fund Dept Amount Program Project $ $ $ $ $ $

Telephone Number at Destination:
Supervisor's Email
Email Carbon Copy to (optional):

---

---

Published by NDSU Accounting Office.
Created by Kris Odland