Name of Traveler:
Traveler's Position and Department:
Purpose of Travel and Destination:
Departure date from the University:
Return date to the University:
Address or Phone Number (In Case of Emergency):
Courses to be Missed by the Traveler:
Provision Made for Handling the Classes to be Missed:
Expense Information:
Travel Expenses to be Paid by: University of Notre Dame Other
For University Allowed Expenses: Account Number and Name: Estimated Cost:
Additional Information:
Please provide any additional information or remarks that you have related to your travels:
If appropriate, please complete the Outside Activities Form and submit it to the departmental administrator in 153 Hurley Hall. Thanks!
