Sample Travel Information Request Form

U.S.-[FOREIGN SITE] Research Experience for Undergraduates (REU)
Department of ABC
XYZ University

Applicant Name:	______________________________________________________
Institutional Contact Information:
Academic Department	__________________________________________
Institution	__________________________________________
Institution Address	__________________________________________
	__________________________________________
Telephone	____________________________
Fax	____________________________
E-mail	____________________________
Home Contact Information (during the academic year):
Home Address	__________________________________________
	__________________________________________
Telephone	____________________________
Fax	____________________________
E-mail	____________________________
Please provide your preferred airport and dates for departure and return; select the airport that is most convenient to either your institutional or home residence before the start of the Program. You must depart from and return to the same airport, and that you must arrive at the international site no later than [DATE]. After the Program office briefs the travel agent with participants’ preferences, you will receive instructions on booking your flights.
Domestic Airport for Departure and Return	____________________________________
Preferred Date of Departure	____________________________________
Preferred Date of Return	____________________________________

Rev. 03/2002

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Last updated April, 2002 by Joan Marler