Division Liaison Travel/Hours Request Form
Name of Liaison
*City/State Zip Code
*Needed if a rental car is requested
Name of Division (one per request)
Rating on Needs Sensing Interview
Requesting Hours (Yes or No)
Requesting Travel (Yes or No)
Dates of Electronic Meetings
Reason for Requesting Additional Hours How is this request tied to the Needs Sensing
Interview? How is this request building
Capacity at the division level?
Reason for Requesting Additional Travel How is this request tied to the Needs Sensing
Interview? Why must travel be encumbered
(in person is better is not acceptable)?
Date(s) of anticipated travel
Rental car or Personal Car If Personal car, why (cost effective)?
If rental car, miles and days? Attach cost estimate from Enterprise or provide
Location of rental car. information requested
Hours granted in Business Ops
Rental Car Days approved
Send to: Yvonne.Holloman@doe.virginia.gov