Travel Request Form

Traveler Name *

First Last

Traveler Email *

Is Deborah Taylor the person who processes your travel? *

Yes
No

Travel Processor's Email *

Is this a Virtual Event? (Zoom, Skype, etc.) *

Yes
No

Does this event have multiple dates with other trips in-between visits to this location? *

Yes
No

Start Date of Trip *

End Date of Trip *

Please list each date on a separate line below *

Name of the business to which you are traveling (e.g. U of A-Fayetteville, UCA, etc.) *

Address of the location to which you are going *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Event Name (e.g. Career Fair, UAMS Day at , etc.) *

Will you need to book plane tickets for this trip? *

Yes
No

Since you need plane tickets, please get with your travel processor to arrange the booking of those.

Once you land at the airport in your destination city, will you need to rent a vehicle? *

Yes
No

Please keep in mind that many hotels offer free shuttle service to and from the airports. Utilize this whenever possible to save money.

Approximate number of miles to be traveled, round-trip *

Will you be using your own vehicle or renting a car? *

Using personal vehicle
Rental car needed

Please keep in mind that UAMS will only reimburse you for the cheaper option, regardless of which one you choose. Mileage reimbursement for driving a personal vehicle is $0.42/mile. Currently a trip of approximately 120 miles round-trip or more will cause the rental car option to be cheaper. If your trip is right around that amount, please download the Rental Car Trip Optimizer worksheet to find out which option is cheaper. If you fill out one of these worksheets, please save it and upload it using the upload file field further down on this form.

From which Enterprise location would you like to pick up the rental car? *

291 NEWMAN DR NORTH LITTLE ROCK, AR 72117
5700 LANDERS ROAD SHERWOOD, AR 72120
1526 WEST MAIN STREET JACKSONVILLE, AR 72076
6523 SOUTH UNIVERSITY LITTLE ROCK, AR 72209
9804 N RODNEY PARHAM RD STE 1 LITTLE ROCK, AR 72227
200 SOUTH BROADWAY LITTLE ROCK, AR 72201
11301 WEST MARKHAM LITTLE ROCK, AR 72211
LITTLE ROCK NATL ARPT LITTLE ROCK, AR 72202

Please keep in mind that vehicle availability may affect which location can be used. Every effort will be made to book at the location you select on this form.

Rental Car Pick-up Date *

Rental Car Pick-up Time *

: HH

MM

Rental Car Drop-off Date *

Rental Car Drop-off Time *

: HH

MM

Driver's License Number *

This is required by Enterprise when booking the rental car. This information will not be shared with anyone else besides Enterprise. If your driver's license was not issued by the state of Arkansas, please put the two-letter state abbreviation in front of the DL#.

Phone Number *

This number will be given to Enterprise so that they can contact you if they need to inform you of a change to your rental car reservation. For this reason, you may want to give a cell phone number instead of your office number.

Since you are renting a car instead of driving a personal vehicle, Travel will reimburse you for what you spend to refuel the car before returning it to Enterprise. Please send that receipt to Rob Tolleson after your trip. You can either scan it and send it to rjtolleson@uams.edu or you can give it to Rob in-person. Travel will not reimburse you for the refueling without this receipt being submitted.

Please use this to upload any documentation you have that shows proof of your intended attendance of this event. This can include flyers for the event, e-mail confirmations from the event organizers, or anything else that you think might work for showing the Travel Department proof of this trip. If using an e-mail, please try to use Outlook to save it as a PDF before uploading it to this form. You may also just forward that email confirmation to your travel processor. You can also use this to upload the Rental Car Trip Optimizer worksheet from above if one was filled out.

Drop files here or

Will you need a hotel for this trip? *

Yes
No

Rob Tolleson will work on getting you a hotel near the event location. If you have a preferred hotel in that city, please let me know your preference in the comments box at the end of this form. We will try to honor your hotel preference if it is within a similar price-range as other hotels in that area.

Hotel Check-in Date *

Hotel Check-out Date *

Please use the space below to let us know about any special notes associated with this trip (optional)

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