Requester Name:	Click here to enter text.	Year in Program:

Destination:	Click here to enter text.	Dates of Travel:	Click here to enter text.

Conference Name:	Click here to enter text.

Conference Type (mark one):	OS/OT Conference	Non-OS/OT Conference

Indicate Attendee Type:

Select Abstract Status:

Transportation
Type	Company, Mileage Info, Etc.	Estimated Amount
$ 0.00
$ 0.00
____ Miles x $0.535/Mile	$ 0.00
$ 0.00
Subtotal Transportation	$ 0.00

Lodging
Name of Lodging	# Nights	Rate/Night Inc. Tax/Fee Estimate	Estimated Amount
$ 0.00	$ 0.00
$ 0.00	$ 0.00
Subtotal Lodging	$ 0.00

Other Approved Expenses
Conference Registration	$ 0.00
Poster Printing	$ 0.00
Subtotal Other Expenses	$ 0.00

Total Estimated Expenses	$ 0.00
Additional Information (e.g., justification for dates/purpose). Please attach a copy of your presentation/abstract acceptance when sending this form. See handbook for more information.
Click here to enter text.
Signature of Faculty Advisor (Required for Processing)	Date
Signature of Dean or Dean’s Delegate (Required for Processing)	Date

Submit this form with faculty advisor signature to: Stephanie Lee at stephanie.lee@chan.usc.edu. Requests must be submitted at least 30 days prior to the date on which the travel will start. Once approved, travel expense reports must be submitted via Concur within 30-days of the completion of travel. Receipts showing the cost and method of payment must be submitted for each reimbursement request.

All students are required to follow all applicable USC policies. For reference, below are the links to the USC Travel Policy and the Supplemental Travel Policy.