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TAR-Participant

VIEWS: 7 PAGES: 3

									         TAR # _______________                                                                                                    Date Received: _________________


             ORAU/ORISE Maryland Non-Employee Travel Authorization/Reservation (TAR)
                      Title:          Dr.           Mr.      Mrs.            Ms.           Miss

  Name (First Middle Last):

   E-Mail:                                                                                               Office Phone #:
Home Street Address:
                               Street, City, State, Zip

             Are you under 25 years of age?                       YES        NO                   Do you have a Diners Club card?                YES     NO
Do you want Airfare and/or Rental Car arrangements to be made by ORAU/ORISE?                                                    YES       NO
Method of Travel:             Plane           POV         Government Vehicle         Other          Passenger     Rental Car size:
                                                                      Note: Additional justification MUST be provided if it is necessary to rent a car larger than mid size

         Purpose of trip:
               Start Date:                                                         Departing City/State:
                End Date:                                                                Return City/State:
Destination City/State:                                                                    Lodging Dates:
Please complete the Multiple Destination Supplement if there will more than 2 destinations
GSA Per Diem Rates Lodging:                                     /night                Meals:                   /day
Will you be needing a lodging waiver?                           YES      NO         Amount Requested:                          /night
      Lodging waiver justification:
Flight Itinerary Airline/Flight #'s/Times (if known) - You may also attach a copy of your preferred travel itinerary
               Departure:
                   Return:
Does this trip include personal travel?                     YES         NO                If yes, please indicate dates:
Are you requesting ORAU/ORISE to pre-pay registration fees?                                        YES    NO   (If yes, a completed registration form is required)

Are meals included as part of the registration fee?                                YES      NO    If yes, which meals are included:             Bkfst      Lunch      Dinner

  If you are attending a conference or formal training please include pertainent documentation such as agenda,
                          registration information, meeting announcement, invitation, etc.
    Event:
  Website:
         Registration Fee:                                                   Date Needed:                                      Payable by credit card:          YES       NO

        Check payable to:                                                                            FAX #:
  Phone #:                                           Address:

     Total Estimate: $                                                                            Request cash advance for meals
                                        from worksheet on page 2                                  Additional advance requested $
                                                                                     NOTE: Advances are approved on a case by case basis only. Justification MUST be
                                                                                                       provided if additional advance is requested.
Remarks/Special Circumstances/Pertinent Information:




     Traveler' Signature                                                            Mentor's Signature

Program Coordinator Approval:

ORAU/ORISE Approval _____________________________________________                                                     MIPR #
             Project/Task:                                                                                                     Travel Particpant
                                                                                                                                                                      Revised 2/1/09
          ORAU/ORISE Maryland Non-Employee Travel Authorization/Reservation (TAR) Travel
                                                    Estimate Worksheet
                                           MUST be complete and submitted with TAR
                           Per Diem*:               days @                           per day     =   $0.00          *Per Diem is calculated
                                                                                                                     at 75% for the first &
                           Per Diem*:               days @                           per day     =   $0.00
                                                                                                                        last day of travel
                           Per Diem*:               days @                           per day     =   $0.00          5 days of travel
                           Per Diem*:               days @                           per day     =   $0.00              = 4.5 x GSA rate
                                                                                                                    9 days of travel
                           Per Diem*:               days @                           per day     =   $0.00              = 8.5 x GSA rate
                             Lodging:               nights @                         per night   =   $0.00
                             Lodging:               nights @                         per night   =   $0.00
                             Lodging:               nights @                         per night   =   $0.00
                             Lodging:               nights @                         per night   =   $0.00
                             Lodging:               nights @                         per night   =   $0.00

                                                           Airfare (US carrier only):            =   $0.00
                          Rental Car:               days @                           per day     =   $0.00
                                                               Estimate @ $50/day
                              Personal Vehicle Mileage
      Round-Trip to/from Destination               miles @                           per mile    =   $0.00
                                                                currently .55/mile
           Round-Trip to/from Airport              miles @                           per mile    =   $0.00
                                                               currently .55/mile
                     Airport Parking:               days @                           per day     =   $0.00
                                                               Estimate @ $10/day
                                                                           Hotel Parking:        =   $0.00
                                         Ground Transportation (taxi, metro, etc.):              =   $0.00
                                                          Rental Vehicle Gasoline:               =   $0.00
                                             Misc (taxes, materials/supplies, etc.):             =   $0.00
                                                                      Registration Fee:          =   $0.00
                                                TOTAL ESTIMATED EXPENSES:                        =   $0.00

                                     Per Diem & Lodging rates are verified at www.gsa.gov
                                        Mileage is verified at www.randmcnally.com
                 To expedite processing, please obtain proper approval signatures PRIOR to submission.
          It is not necessary to submit original Travel Authorization/Reservation documents, copies of these forms are acceptable
  Please submit your travel request at least 2 weeks prior to your departure date for CONUS travel and 75
                                days prior to departure for OCONUS travel.
                        Please submit TAR & any other pertinent information to:
                             ORAU/ORISE Maryland, ATTN: Brooke Elkins
                         4692 Millennium Drive, Suite 101, Belcamp, MD 21017
             E-Mail: ORAUMaryland@orau.org ♦ Fax: (410) 306-9306 ♦ Phone: (410) 306-9208

Do you know about the Diners Club International Corporate Card? It is a credit card offered to ORAU/ORISE participants for
travel purposes. With this card you can pay for travel expenses like rental cars, airfare, registration fees and lodging as well as
obtaining a cash advance to cover your meals. If you submit your properly completed TES in a timely manner, you will receive
your reimbursement in time to pay your bill. It's a great offer that many travelers take advantage of. Please visit our website
http://www.orau.org/maryland or contact our office for an application.

                                                                                                                                    Revised 2/1/09
      ORAU/ORISE Maryland Non-Employee Travel Authorization/Reservation (TAR)
                           Multiple Destination Supplement
               Initial Starting Information:
                                                         Date                                    City/State

                 Final Return Information:
                                                         Date                                    City/State

Destination 1
             Start Date:                                   Departing City/State:

             End Date:                                   Destination City/State:

             GSA Per Diem Rates: Lodging                   /night            Lodging Dates:
                                       Meals               /day               Lodging Waiver Needed?          YES   NO

     Lodging waiver justification:                                                  Amount Requested                /night

        Flight Itinerary (if known):

Does this portion of the trip include personal travel?          YES   NO   If yes, please indicate dates:


Destination 2
             Start Date:                                   Departing City/State:

             End Date:                                   Destination City/State:

             GSA Per Diem Rates: Lodging                   /night            Lodging Dates:
                                       Meals               /day               Lodging Waiver Needed?          YES   NO

     Lodging waiver justification:                                                  Amount Requested                /night

        Flight Itinerary (if known):

Does this portion of the trip include personal travel?          YES   NO   If yes, please indicate dates:


Destination 3
             Start Date:                                   Departing City/State:

             End Date:                                   Destination City/State:

             GSA Per Diem Rates: Lodging                   /night            Lodging Dates:
                                       Meals               /day               Lodging Waiver Needed?          YES   NO

     Lodging waiver justification:                                                  Amount Requested                /night

        Flight Itinerary (if known):

Does this portion of the trip include personal travel?          YES   NO   If yes, please indicate dates:


Destination 4
             Start Date:                                   Departing City/State:

             End Date:                                   Destination City/State:

             GSA Per Diem Rates: Lodging                   /night            Lodging Dates:
                                       Meals               /day               Lodging Waiver Needed?          YES   NO

     Lodging waiver justification:                                                  Amount Requested                /night

        Flight Itinerary (if known):

Does this portion of the trip include personal travel?          YES   NO   If yes, please indicate dates:
                                                                                                                    Revised 2/1/09

								
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