Travel Requisition Form

Name(Required)

First Last

Email(Required)

Campus Email

Phone(Required)

Personnel Type(Required)

Department(Required)

Department and Campus (ex. Electrical Engineering/CUNY)

Research Theme & Area(Required)

Name of Mentor/Advisor/Supervisor(Required)

Did your mentor/supervisor approve this trip?(Required)

Conference or Meeting Name(Required)

Provide Full Conference Name

Conference or Meeting Location(Required)

Conference or Meeting Start Date(Required)

Conference or Meeting Date (i.e. MM/DD/YYYY

Conference or Meeting End Date

Conference or Meeting End Date (i.e. MM/DD/YYYY

Upload your Abstract/poster/presentation

Accepted file types: pdf, docx, pptx, ppt, doc, Max. file size: 2 MB.

If available, please provide a copy of your poster/abstract/presentation (if this is larger than 2MB, please email cessrst@ccny.cuny.edu)

Purpose & Justification of Travel(Required)

Provide a description/justification of your participation

Estimated Air Fare/Ticket/Train/Bus

Please enter a number from 0 to 2000.

Estimated Hotel Fare/Housing

Please enter a number from 0 to 9000.

Estimated Registration Fee

Please enter a number from 0 to 5000.

Other items

Please enter a number from 0 to 5000.

Estimated Costs (Totals)

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