DEPARTMENT OF AFRICAN AMERICAN AND AFRICAN STUDIES

TRAVEL REQUEST FORM

Cheikh Thiam
thiam.5@osu.edu
Email:______________________________________
6072379308
Travelers Name:____________________________
Phone:

_________________________________

Rank (Select One):

Full Professor
Associate Professor
Assistant Professor
Visiting Assistant Professor

Lecturer
Staff
Guest

Purpose of Travel:

Research
Conference
Other
If Other: (Specify) ____________________________________________________________
____________________________________________________________________________
Time and Location Information
Departure From:

_____________________________

Destination:

_____________________________

Date/Time of Departure

_____________________________

Date/Time of Return

_____________________________

Columbus

Nuremberg
6-2-2015
8-5-2015

Brief Explanation (150 words or less)

I am presenting a paper at the annual conference of the African Literature Association.

Please note that although the conference is from 6-2-2015 to 6-6-2015, I am requesting
a return date for 8-5-2015 because I plan to do research at the colonial archives in Aixen Provence in June and July. Please note that this will have no negative effects for the
university because the return ticket of 8-5 is $1000 cheaper than what the university
Are you requesting a cash advance?
would
have paid if I was to come back right after the conference on 6-2-2015. Note also

Yes
that I plan to my research time in Aix-En-Provence after the conference with my own
personal
funds.
No

Are you requesting pre-payment?

If yes, check the appropriate box(es) below:

Yes
No

Airfare
Registration Fees
Car Rental (University Motor Pool or
University Approved Rental Agent)
1

Do you have a research account?

Yes
No
Source of Funding

AAAS
College
Research
Other
French and Italian

If Other:

____________________________________

Estimated Travel Expenses

Airfare
Lodging
Registration
Per Diem ($25 flat rate w/o receipts)
Transportation (shuttle, taxi, train, etc.)
Personal Vehicle (Federal mileage rate is 56.5 cents/mile)
Parking
Car Rental
Amount Pre-Paid by Department [Department Only]
Travelers Total Expenses

$ 1736
$ 450
$ 200
$ 200 meals
$ $100
$
$
$
$
$ 2686

TRAVELERS SIGNATURE _____________________________________ DATE __________________

Instructions: Travel requests must be approved by the Chair prior to any arrangements being made.

Please complete this form in its entirety and submit it with supporting documentation (i.e. letter of
invitation or email invitation) or a schedule showing your participation in the conference to the Program
Assistant.

Travel request must be submitted to the Program Assistant at least three (3) weeks prior to the date of
travel for processing. Travelers have up to forty-five (45) days after the return to submit receipts for
reimbursement to the Academic Program Coordinator.

If you are requesting prepaid registration, a complete registration form must accompany this travel
request.

The Department will reimburse for meals if the traveler provides receipts for all meals. Otherwise, the
department will pay a flat rate of $25 per day. [PLEASE NOTE THAT ALL REIMBURSEMENTS WILL BE
DEDUCTED FROM YOUR TRAVEL BUDGET.]

The University requires the use of its pre-approval travel agencies if the Department prepays the airfare.
For Office Use Only
Authorizing Signature ___________________________________

Date ____________________________

Special Comments: ________________________________________________________________________________

Chartfield Info:

Org______________

Project_________________________________

Fund_______________
Program________________________

Acct_____________