The Gail & Richard Lumpkin School of Nursing - Travel Application Form

Please fill out this form and submit at least 2 weeks prior to travel.

EIU Travel Info: https://www.eiu.edu/purchasing/travel.php

Today's Date Today's Date * / MM / DD YYYY
Name Name * First Last
Email *
Checkboxes - check only one *

Checkboxes - check only one Employee Only Attending Employee Presenting/Mentoring
Purpose of Travel: *
Destination *
Departure Date Departure Date * / MM / DD YYYY
Return Date Return Date * / MM / DD YYYY
Personal Vehicle Estimated Cost: Use $ .40 per mile if fleet vehicle is available, 62.5 per mile if no fleet is available.

Daily Rates for University vehicles are as follows (whichever is greater) these rates include fuel:
Sedans:
$12 for 4 hours or less or 40 cents per mile
$25 per day or 40 cents per mile * $ Dollars . Cents
Lodging - if overnight. ($28/day in-state, $32/day out-of state)

Illinois preferred hotels can be found here: https://cms.illinois.gov/employees/travel.html

Per Diem/Hotel allowances: https://cms.illinois.gov/employees/travel/travelreimbursement.html * $ Dollars . Cents
Extra Expenses - tolls, parking... * $ Dollars . Cents
Registration Fees * $ Dollars . Cents
Funding Source *

Funding Source School of Nursing Funds Out of Pocket