Employee Travel Request Form

Mountwest employees complete this form prior to any travel.

Employee Information
942 Number*
Name*
First Middle Last
Phone*
Email*
Employee Type*
Department/Unit*
Immediate Supervisor's Name*
Immediate Supervisor's Email*
Trip Information
Reason for Travel*
Mode of Transportation (Air, Driving)*
Date of Departure*
MM slash DD slash YYYY
Date of Return*
MM slash DD slash YYYY
Please describe destination(s), including city/state and/or country.*
What type of facility (Hotel, condo, family member, etc.)?*
Will you be residing with any non-household members?*
- Yes
- No
Are you planning any stops prior to destination (Overnight hotel stay, dining, etc.)? If so, please provide details.*
Emergency Contact
Please identify an emergency contact outside the college. Provide their name, their relationship to you, e-mail address and phone number.
Name*
First Last
Phone*
Email*
Relationship*
Returning Information
Are you aware that, depending on your destination, you may be required to complete 5-14 days of self-isolation and/or telecommuting before returning to work on site?*
- Yes
- No
Are you aware that, after any required self-isolation or telecommuting due to personal or business travel, you must have written approval from your supervisor before you return to work on site?*
- Yes
- No

Employee Information