| Name | ______________________________________________________ |
| Destination | ______________________________________________________ |
| Dates of Travel | ______________________________________________________ |
Purpose of visit (research/creative work, presentation, professional development leave, etc.; include host or organization):
If presentation, has the paper been accepted? Yes No
Title and/or description of presentation (attach abstract):
Of what benefit will this trip be to BYU, the College, and your department?
| Proposed budget: | Airfare | $_____________________ |
| Local Transportation | $_____________________ | |
| Meals | $_____________________ | |
| Lodging | $_____________________ | |
| Other (describe) | $_____________________ | |
| TOTAL | $_____________________ |
How much of the proposed budget will be covered by the department, host, or other sources?
Amount requested $________________
I will_____ or will not_____ go if I receive a reduced amount from that requested.
| Department Recommendation: | _____________________ | _____________________ |
| Department Chair | Date |