PharmT Travel/Leave Request Form » Department of Pharmacology & Therapeutics » College of Medicine

UF requires any employee (faculty, staff, fellows, students) representing the university in any capacity related to their employment, to provide the following information at least 2 weeks before travel. Please complete this Travel/Leave Request Form (even for travel that will be paid for by a third party).

"*" indicates required fields

For your leave, are you representing the university in any capacity related to your employment*

Example: faculty/staff/fellow/student traveling to a conference, meeting, or collaboration effort (paid by UF funds or comped by third party).

Yes (Multi-Day Travel & Leave Request)

Yes (Same Day Travel ONLY & Leave Request)

No (Personal Leave Request)

Legal Name (Last Name, First Name)*

Please select your name from the drop-down box.

Legal Name (Last Name, First Name)

Please type your legal name below.

UF Email*

Supervisor's Email*

Please choose your supervisor’s email (may be different than your mentor)

Mentor's Email*

Please choose your mentor’s email (if different than your supervisor of record.) Leave default uf-pharmacology@ufl.edu if supervisor & mentor are the same.

Type of Leave Requested*

Sick Leave

Vacation Leave

FMLA Leave

Leave without Pay

Bereavement Leave

Bereavement Leave – Provides up to two days of administrative leave upon the death of an immediate family member as defined by the University of Florida.

Start Date of Requested Leave*

MM slash DD slash YYYY

Start Time*

Hours

Minutes

AM/PM

End Date of Requested Leave*

MM slash DD slash YYYY

End Time*

Hours

Minutes

AM/PM

Type of Travel*

Domestic Travel (In-State)

Domestic Travel (Out-of-State)

International Travel

Travel Event Type*

Travel Event Type: Other*

Describe the business purpose of your travel

Name of Travel Event*

Include name of conference/meeting/event/etc. you are attending

Additional Travel Details*

If invited to speak or meet with collaborator, please include: University & Department Name -OR- Name of Collaborator & Affiliate University/Dept Name or Company Name

Benefit to Grant or University/Description of Travel*

Describe how the expense directly benefits the funding source – Define any acronyms entered (500 char. max)

Business Travel Start Date*

MM slash DD slash YYYY

Business Travel End Date*

MM slash DD slash YYYY

Destination*

Only include final destination location

Will this travel include personal travel?*

Choose “yes”, if traveling to business travel location more than 1 day before needed (if domestic) or 2 days before needed (if international).

Yes

Personal Travel Dates*

Include all personal travel date(s) ranges while on UF business travel. Formatted as mm/dd/yyyy – mm/dd/yyyy.

Are you taking UF property?*

This includes a UF laptop, equipment, etc.

Yes

Personal Travel Dates*

Include all personal travel date(s) ranges while on UF business travel. Formatted as mm/dd/yyyy – mm/dd/yyyy.

Is this trip partially or fully paid by a Third Party (or Self-Funded)?*

Travel paid by a third party is also known as complimentary travel or comp travel. Choose “yes” if another party (including self) will pay for your airfare/lodging, etc. without requesting reimbursement on certain or all expenses.

Yes, partially

Yes, fully

Sponsor Name (Third Party Comped Travel)*

Please list name of company/entity/self that is compensating your travel expenses either partially or fully.

What chartfield are you using to pay for this travel?*

Chartfield: Dept ID – Fund Code – Program Code – Source of Funds – Project # – Flex Code (if needed)

Expected Expenses*

Choose all expenses that will be used while on travel. Even if travel is comped, choose all expense options that will be paid by the University of Florida AND/OR the 3rd Party. This is required to ensure an employee is not requesting reimbursement of comped travel.

Airfare

Lodging

Registration Fee

Rental Car

Mileage

Other Ground Transportation (Taxi/Uber/Train/Bus)

Travel Meals

Other Travel Expense

Departing & Returning Airport*

Usually same airport, but if different please note above.

Departure Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Return Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Estimated Airfare Cost*

Will airfare expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Lodging Check-In Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Lodging Check-Out Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Lodging Destination*

Estimated Lodging Cost*

As a reminder, if using personal travel (before or after the requested UF business travel) you cannot use UF funds to pay for lodging nights that are personal travel nights.

Will lodging expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Estimated Registration Cost*

Will registration expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Car Rental Pick-up Location*

Car Rental Drop-off Location*

Car Rental Pick-up Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Car Rental Drop-off Date*

Do not include personal travel dates.

MM slash DD slash YYYY

Estimated Rental Car Cost*

Will rental car expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Estimated Number of Miles (To Destination)*

Estimated Number of Miles (From Destination)*

Will mileage expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Estimated Other Ground Transportation Cost(s)*

Will other ground transportation expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Travel Meals – Number of Days*

Count number of days that you will be traveling (for business purposes only) that you will need to be reimbursed for meals. Do not include personal travel days.

Will travel meals be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Other Travel Expense (Explain):*

Estimated Cost of Other Travel Expense*

Will this other travel expense be compensated by another party (or self-funded)?*

Choose “yes” if a third party (or self) if paying for this cost on your behalf, and you will not be requesting reimbursement (with UF funds) for this expense upon return.

Yes

Upload Agenda/Program/Invitation*

Include meeting agenda, conference program, training/professional development program, and/or speaker invitation.

Max. file size: 125 MB.

Flight Cost Comparison*

If traveling to business travel location more than 1 day before needed (if domestic) or 2 days before needed (if international), you are REQUIRED to complete a cost comparison of flight costs for both dates (flight including personal travel dates & flight not including personal travel dates). If the flight with personal travel dates cost more, you will be responsible for the difference, and UF will cover the cost of airfare comparison without personal travel dates. You may re-do this cost comparison at the time you purchase your flight (as costs change), if you do, please submit the new cost comparison when completing your expense report.

Max. file size: 125 MB.

Confirmation of International Travel Registration:*

All University of Florida faculty, staff and graduate students who are traveling abroad on University business (such as conferences, research, meetings, etc.) are required to register with the UF International Center prior to initiating travel. Please follow the link at the bottom of this website (https://internationalcenter.ufl.edu/travel/online-travel-registration) and upload a screenshot of the confirmation page here.

Max. file size: 125 MB.

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