IPSGA Travel Application and Expense Form
Date SubmittedOrganization NameCoordinator NameCoordinator E-mailCoordinator PhoneName of Activity
(Please continue the sentence with 20 words): For the purpose of:
Purpose of TravelDeparture and Return DatesDestination$0.00Total Amount RequestedDate SignedCoordinator's Signature
*Electronic Signature is not necessary, we can accept full name followed by initials
Anticipated Expenses (attach information if needed!)
Type of ExpenseDescription of ExpenseCost per Item# of Itemsotal ExpensesAirfare
Lodging (# of rooms AND # of nights)
Non-IPSGA Funding (explain and enter total)
Events must be open to all students. Requests must be submitted at least 30 days prior to the date of the event. Please Consider: 30 Days is often n
Please submit online at: www.ipfw.edu/stugov/documents/funding_request_form.html (Underneath Heading: "Travel Request Form"
Thank You for participating in your Student Government!
Attach a submissionexplaining in detail thetravel's categorizationunder the IPSGA TravelPolicy Section II. B.