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Summary: REQUEST FOR OUT-OF-STATE TRAVEL
Department of Molecular and Integrative Physiology
University of Kansas Medical Center
Date: __________________
Home
Name: _________________ Address: _____________________
Title: _________________ ______________________
______________________
First Meeting: _______________________________________________________
Location: ________________________________________________________
Second Meeting: _________________________________________________________
Location: _________________________________________________________
Dates of Official Business: Beginning ____________ Ending _______________
Travel Dates: From __________________ To __________________
Amount Grant/Funding #
Airfare*
(REQUIRED)
Personal Vehicle Mileage (automatically determined by PeopleSoft,
maximum of 60 miles @ .40/mile)
Lodging
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