Funding

Types of Accounts

1. Staff Programming Account (29-0211-0050, XXX, RES, 32180, P01-P03

Budget provided by Area Coordinator. Funds used for Staff Training and Development (P01) Funds used for RA Programming (P03) This account is also the source for all committee funding (P04-P14) When using funds from this account, all required paperwork must be

filled out by staff using the funds. This account will not roll over year to year.

*NOTE: Funds from this account may NOT be used to finance fundraisers.

All of the accounts listed are maintained by DHFS except for the SALD account, which is maintained by the Student Organization Bank in the Student Services Building.

Types of Accounts2. Student Activities Account (29-0215-0050, XXX, RHC,

32181, SG1) This is the RHC Account. URHA receives $10.00 per resident and then gives each hall a portion

of this ($7 to each hall, $2 to URHA, & $1 to the Travel SG2 account). Used for both RHC and RA programs. RHC must approve all expenditures from this account. Also used to purchase equipment for the hall (movies, sporting

equipment, etc.). When using funds from this account, RHC officers must fill out all

required paperwork. This account WILL roll over from year to year.

*NOTE: Funds from this account may NOT be used to finance fundraisers.

Types of Accounts3. Student Organization Bank (Student Activities and Leadership

Development or “SALD” Account This is the only account that does not consist of University funds. The funds

are raised by the students and deposited in this account. All funds raised must be deposited into this account.

Tax is charged on purchases, but purchases are not held under the same restrictions as purchases with University funds.

Account information and budget is from the Student Organization Bank. This account is an independent checking account held by most RHCs. The

“bank” is located at 4.304, SSB. Your RHC must be a Registered Student Organization in order to maintain an

account at the bank. Each RHC maintains its own signature requirements for accessing money from

the account. Money can be used for any hall purpose. These are the only funds available if reimbursement is needed. Maintained by RHC. It is strongly recommended to have an AHC/HC involved

with this account.*NOTE: Funds from this account MAY be used to finance fundraisers.

Types of Accounts4. Student Travel (29-0215-0050, RHC, RHC, 32181, SG2)

This account is used to fund transportation for programs and conferences.

RHC, RA or Professional Staff may request funds from this account. The advisor to URHA handles all requests to this account. $1 per resident goes into this account each year.

Types of Accounts5. Outside Program Account (29-0215-0050, RES, RHC,

32181, SG3) Sometimes RAs will offer programs where money may need to be

collected from the participants (taking a group to a play, game, tubing, etc.). In these instances the program may only be partially funded and require the participant to pay for part of his/her fee.

In these cases, the RA will not collect cash. Instead, the RA will have each resident participating in the program sign the “Program Charge Authorization” form. This authorizes DHFS to add the authorized amount to the student’s next housing bill.

When payment is made to the vendor, the funds will be taken from this account.

When the students pay their Housing bill, their payment for this program is placed in this account.

Types of AccountsCommunity Building Planner and Request for Funds

The University of Texas at Austin Division of Housing and Food Services

Community Building Planner

Title of Community Builder:

Name(s) of Organizer(s): Main Contact’s Name and Phone #:

Brief Description:

Goals:

Date: Time: Location: Resource Person(s) Title Phone Number

Equipment Needed: Date Reserved:

Facilities Needed: Date Reserved: Type of Community Builder-Please check only one: Social Faculty Fellow Passive Knowledge Building (select from these four)

Human Awareness Personal and Emotional Health Personal Values and Intellectual Development Academic and Professional

Target Audience-Please check only one: Your Community Area/Building All-campus Specific Population:

Anticipated Attendance: Faculty Fellow Invited? If no, why not? Type(s) of Publicity: Door to Door Word of Mouth Invitation Daily Texan Table Tents Banners Flyers UTV Date Publicity Campaign Starts: Planner Approved: (HC initials)____________

Request For Funds (check which account(s) funding is requested from) Detailed description of item(s) (Use back of form if necessary)

Item # Unit $ Total $ Item # Unit $ Total $ 1. 2. 3. 4. 5. 6.

Program Account: 29-0211-0050, (Select One), RES, 32180, (Select One) Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

Insurance Account: 29-0215-0050, RES, RHA, 32181, SG4 Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

Student Activities (RHA): 29-0215-0050, (Select One), RHA, 32181, SG1 Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

Student Contribution Account: 29-0215-0050, RES, RHA, 32181, SG3 Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

URHA Travel Account: 29-0215-0050, RHA, RHA, 32181, SG2 Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

Other Account: Account #: Payment Form: (Select One) (IDT Account #: ) Total $ Requested:

Vendor Information: A request of $2500 and higher requires a minimum of one telephone bid. Must provide written justification if vendor used is not the low bid. Important: Purchases over $150 at any one vendor must be in good tax standing with the State Comptroller Office. Go to http://ecpa.cpa.state.tx.us/coa/coaStart.html to check status. Print the status sheet and turn in with this form.

Vendor Name: Person Contacted: Address: Zip: Phone: Vendor ID# (needed for PO’s):

______________________________ ________ ______________________________ _______ Requester of Funds Date Hall Coordinator Date

______________________________ ________ ______________________________ _______ Residence Hall Association Representative Date Area Coordinator Date

Types of AccountsDIVISION OF HOUSING & FOOD SERVICE

PROGRAM CHARGE AUTHORIZATION

EVENT: ______________________________________________________________________ SPONSORING RA/RHA: ________________________________________________________ AREA (circle one): Jester Waller Creek Whitis DATE(S) OF EVENT: ___________________________________________________________ DESCRIPTION OF ACTIVITY: __________________________________________________ HC APPROVAL: _______________________________________________________________ CHARGES TO BE MADE TO: 29-0215-0050, RES, RHC, 32181, SG3 / SG4

Student Name

UTEID Program Cost

Insurance Rate Per

Day

# of Days

Insurance Total

Total Charge

Signature

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $ $

$

$2.00 x $

$

$

$2.00 x $

$

$

$2.00 x $

$

$

$2.00 x $

$

$

$2.00 x $

$

By signing this form, I am authorizing the Division of Housing and Food Service to charge my account for the amount designated for this program. If, for some reason, I do not attend the program, I understand I will not receive a refund. I also agree to pay for this event within 30 days of the event or be subjected to a $10 late fee.

Types of Accounts6. Student Insurance Account (29-0215-0050, RES, RHC,

32181, SG4) Any time a student participates in a potentially dangerous activity,

the student must provide proof of health insurance. If the student does not have health insurance, he/she must purchase

temporary health insurance. They can do this by paying $2 per day. To do this the student will sign the “Program Charge Authorization” form. This authorizes DHFS to add the authorized amount to the student’s next Housing Bill.

When payment is made to the insurance company, the funds will be taken from this account.

When the students pay their Housing bill, their payment for insurance is placed in this account.

Types of AccountsTHE UNIVERSITY OF TEXAS SYSTEM

REQUEST FOR SPECIAL EVENTS COVERAGE ACCIDENT AND SICKNESS INSURANCE

EVENT: __________________ SPONSORING DEPARTMENT: Division of Housing and Food Service AREA (circle one): Jester Waller Creek Whitis DATE(S) OF EVENT:__________________________ NUMBER OF DAYS NUMBER OF COVERAGE DESIRED: _________________ PARTICIPANTS: METHOD OF DESTINATION: TRANSPORTATION: ______ DEPARTMENTAL CONTACT: Anna Villarreal-Ramírez PHONE: 512/232-2898 CAMPUS ADDRESS: 200 W. Dean Keeton Street, Austin, Texas 78705 ACCOUNT NUMBER AND TITLE: 29-0215-0050, RES, RHC, 32181, SG4

THE FOLLOWING PERSONS ARE TO BE INSURED FOR THE ABOVE EVENT:

(Additional pages may be attached if necessary)

Name EID Birthdate

Methods of Payment1. Procard

The ProCard is a MasterCard issued to each Area Coordinator and some Hall Coordinators. It is used to make purchases of large or small dollar amounts.

Purchases up to $249 may be approved by the AC. Anything above that requires the Associate Director’s approval.

Student leaders cannot check out the ProCard. Only staff members can use the ProCard.

The ProCard cannot be used to purchase live flowers, travel, gasoline, postage, campgrounds, or food at restaurants. (Pizza vendors are considered restaurants)

All purchases must be from vendors in good standing with the Texas Comptroller. See http://ecpa.cpa.state.tx.us/coa/coaStart.html for status of vendors.

Purchases over $999 from a single vendor cannot be made on the ProCard. Each Area Coordinator will have guidelines for ProCard use and checkout. In

addition, the University Purchasing Office has set guidelines, limits and restrictions. See http://www.utexas.edu/admin/purchasing/procard/for more information.

Methods of Payment Procard (continued)

How It Works: The RA or RHC officer reserves the ProCard in the Area Office using the ProCard and Pizza Card Reservation form (if RHC is making the reservation, an RA must take the responsibility of picking up the card and make the purchase). The RA signs out the Procard from the Area Office on the pre-arranged date. The RA goes to the vendor and makes the purchase. The RA returns the ProCard and the signed itemized receipt (with no tax charged) to the Area Office.

Methods of Payment2. Pizza Card

The pizza card may be used to make purchases from Jest-A-Pizza, Jester City Market, Kins Market, Cypress Bend, and Jester Texas Store.

Each hall and each RHC has an assigned pizza card. When the card is swiped, money is drawn from the corresponding account.

This requires the approval of the Area Coordinator. A pre-determined amount of money is assigned to the pizza card. How It Works: The RA or RHC officer reserves the pizza card using

the Procard and Pizza Card Reservation Form. The RA or RHC officer picks up the card on the pre-arranged date, goes to the location where they will be making the purchase, places their order and pays for it. Then they need to return the card and the signed receipt to the Area Office.

*NOTE: It is recommended that the RA or RHC officer call the location on the day of pick-up to confirm that the order is on track.

Methods of Payment

PROCARD AND PIZZA CARD RESERVATION FORM

This form is to reserve the Procard or Pizza Card. Please complete the following information and return it with the Request for Funds form. You will be notified by phone if there are any problems with your reservation. Which card are you requesting? Procard Pizza Card Name: Building/Room: Phone: Area: Select One HC’s Name: When would you like to check out the card? Date for check-out: Time: Select One, Select one Date for return: Time: Select One, Select one NOTE: These cards can only be checked out from the Area Administrative Assistant’s Office, which is open Monday-Friday 8am-noon and 1pm-5pm. The person who checks out the card is the ONLY person authorized to use it.

Methods of Payment3. Petty Cash

Used for purchases of $25 or less. Two petty cash requests may be used for one program. If two are used, two

different people must pick up the petty cash (max $25 each). This requires the approval of the Area Coordinator and is then routed to the

Associate Director. It takes three working days to process a petty cash request. RA or RHC leader must pick up money from DHFS Accounting Office (M-F; 8:30

am to 4:30 pm. Receipts, signed vendor copy and any change must be returned to the DHFS

Accounting Office. (Your AC may also require a copy of the receipt for his/her records).

If petty cash was used to purchase gift certificates or prizes, the recipient’s name, signature and EID are required to be turned in to Accounting.

If two petty cash requests are used, the receipts must be separate and neither receipt can show more than the amount specified on a single petty cash form ($25 max).

The AC may have additional requirements for reporting the exact amount of the purchase or bringing a copy of the receipt to the Area Office.

Methods of Payment Petty Cash (continued)

How it Works: The RA or RHC officer picks up the petty cash and corresponding petty cash form from the DHFS Accounting office. RA or RHC officer goes to vendor, purchases items and has the vendor sign the petty cash form. Before leaving the store, the RA or RHC officer confirms that there is no tax charged and that the receipt is itemized. Within 48 hours of pick-up, the RA or RHC officer returns the receipt and any change to the Accounting office and follows any additional steps set by the AC.

Methods of Payment

The University of Texas at Austin Division of Housing and Food Service

AUTHORIZATION FOR PURCHASE – PETTY CASH

VENDOR: This is to certify that the item(s) being purchased via cash payment are for The University of Texas at Austin, Division of Housing and Food Service. Purchases made for State use are exempt from the State Sales Tax – Art. 20.04 (F) 3, Chapter 20, Title 122A Taxation, General R.C.S. 1925 as amended by the 57th Legislature First Classed Session, 1961. Would you please fulfill this request and complete the vendor section of this form? You assistance is appreciated.

Laurie Mackey, Associate Director VENDOR: Date: June 8, 2006 Firm Name: Vendor Name Total Cost $25.00 Vendor Signature

***************************Use of Division of Housing and Food Service**************************

Date: June 8, 2006 Requested by: RA 495-xxxx xxxxxxxx@mail.utexas.edu (Name) (Phone #) (Email) Requested item(s), amounts, purpose: Whatever the program may be Account Name and Number: 29-0211-0050 Bldg: RES Sect: RES Code: 32180 Project/Item No: P0X Authorized by: ______________________________________________ Tax Exempt # 74-6000203

Methods of Payment4. Food Request

Used to order food for programs, staff development, etc. from DHFS Food Service. (A 3-working day notice is needed for party pack and a 5-working day notice is needed for other orders.)

Food orders up to $249 may be approved by the Area Coordinator. Anything above that requires the Associate Director’s approval.

The Area Office must receive a receipt from Food Service. Each area has different methods for receiving the receipt, which may involve the RA or RHC officer.

How it Works: The RA or RHC officer fills out the Request of Food form. On the date of the program the RA or RHC officer picks up the food from the designated location (Kinsolving or Jester). If this is required, the RA or RHC officer brings the receipt to the Area Office.

Methods of Payment Division of Housing and Food Service

REQUEST FOR FOOD

Form must be completed, signed and received by Food Service a minimum of 5 working days prior to event.

___________________________________________ For Accounting Use Only: Name of Sponsoring Organization/Resident Assistant

Food Cost ________ ___________________________________________ Location of Event Supplies Cost ________ ___________________________________________ Income ________ Purpose of Event ___________________________________________ ____________ _____________________________________ Date and Time of Event # Attending Date/Time/Location of Pickup

___________________________________________________________________________________________________ Benefit to the University _____________________________________________________________________________________________________________ Group(s) Attending (If 10 or fewer attend, attach list including names of participants, titles, affiliations) Charge to Name and Number______________________________________________________________________________________ Bldg____________ Sect______________ Code______________ Project/Item #_______________ Quantity Item Unit Cost Total Cost

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

Total Amount ______________

Requester is responsible for pickup, delivery of food/equipment, and if applicable, return of food/equipment by 12:00 noon on the day following the event. ______________________________________________ _________________________________________ Requester’s Signature Phone Number Area Coordinator’s Signature and Date ___________________________________________________ ____________________________________________ Hall Coordinator’s Signature and Date (Req. for Student Functions) Assistant Director’s Signature and Date -Orders over $250.00 I acknowledge that the food and/or beverage I ordered and received from the Division of Housing and Food Service, the University of Texas at Austin, is in good and sanitary condition. I further understand and acknowledge that having taken possession, I am now fully and solely responsible for the safe and sanitary handling and distribution of this food and/or beverage. _________________________________________________________ _________________________________________________ Requester’s Signature at Time of Pickup Food Service Supervisor’s Signature and Date Page_____of_______ Food Service: White Copy Unit: Yellow Copy HF5601 (REV. 6/99) Accounting: Pink Copy

Methods of PaymentBurger Burn Sign-Up

$3.57 in Dine In Dollars will be deducted for each meal Date of Burger Burn __ _______ Time of Burger Burn _______

Location of Burger Burn ___________ _

Building and Section/Floor

RA/RHC Officer collecting names and UT EID’s _______________________________

____________________________________Phone# _____ _____________________

Resident’s Name Room # Resident’s UT ID

(600861________)

Burger OR Hot dog OR Veggie

burger?

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24.

Methods of Payment5. Purchase Order

Used to make purchases where petty cash and ProCard cannot be used because of the vendor or the amount you plan to spend.

This requires the approval of the Area Coordinator and is then routed to the Associate Director.

A purchase order is a promise of payment to a vendor. Accounting sends a check to the vendor after services are received.

A purchase order requires that the vendor be willing to accept purchase orders and be an established vendor with UT.

It takes 10-working days to process a purchase order from the time the request goes to Accounting to the time it is returned to you.

How it Works: Typically, the RA or RHC officer picks up the vendor copy of the purchase order at the Area Office. The RA or RHC officer receives the service or product, gives the vendor the appropriate copy of the purchase order and then receives a receipt. The RA or RHC officer brings the receipt to the Area Office.

Methods of Payment6. IDT (Interdepartmental Transfer)

Like a purchase order, an IDT form is a promise of payment. Accounting transfers funds to the vendor/department after the services are received.

An IDT is used to transfer money from one DHFS area to another (e.g. Jester to Kinsolving) or from DHFS to another campus office (e.g. Recreational Sports, University Printing).

IDTs up to $249 may be approved by the Area Coordinator. Anything above requires approval from the Associate Director.

Other departments, such as Rec Sports, may have additional IDT authorization forms to be picked up by the RA or RHC officer and signed by the Area Coordinator along with the DHFS IDT form.

How it Works: The RA of RHC officer goes to the Area Office, picks up the completed IDT form, and brings it to the appropriate department. The RA or RHC officer gets a receipt for services and brings it back to the Area Office.

Methods of Payment

The University of Texas at Austin

Division of Housing and Food Service PURCHASE ORDER

Date __________ Vendor Name/Phone # __________________________________________ Requestor/Phone # _________________________Received Date/Initials _________________ Purchase Order Number ______________ Approval Initials _____________________________ BLDG SECTION HF/CODE ITEM/PROJ UNIT ACCOUNT NUMBER DESCRIPTION AMOUNT

TOTAL

This form to be used for UT vendors (i.e. Printing, Rec. Sports, Texas Union, Daily Texan, Thompson Conference Center.) Also to be used for registration, subscriptions, and advertisements. HF1131 (2/99)

Methods of Payment7. Check

These are very rare and only used as a last resort when no other method of payment is possible. It is recommended that the Area Coordinator is involved when determining whether or not a check can be used.

A check is usually used when hiring an individual for professional services (e.g. dancers or musicians for cultural dinners).

A check requires a signed purchase order and invoice or an Authorization for Professional Services, Payee Information Form and Request for Approval of Expenditures and Official Occasions and Other Expenses Form sent to Accounting for timely processing of payment.

How it Works: The appropriate forms are filled out and routed to the Area Coordinator and then to the Associate Director. Services are received and then the check is cut.

*NOTE: A check is not one of the options on the Program Planner/Request for Funds.

Travel Paperwork1. Release and Indemnification Agreement

This form is a waiver that must be filled out by any resident attending a trip that is potentially dangerous. It would also be filled out whenever the program is 25 miles or more from the UT campus. Resident Assistants do not need to fill out a Release and Indemnification Agreement.

2. Request for Travel This form is used only by staff members. Whenever travel is required

25 miles or more from the UT campus, this form must be filled out. Staff is required to have this form submitted to the Associate Director at least 5 working days before the date of travel.

3. Insurance For programs that are potentially dangerous or require travel 25

miles or more from the UT campus, insurance is required for each participant. If the participant has their own insurance, the RA must photocopy the insurance card and attach it to the Release and Indemnification Agreement.

Travel Paperwork Insurance (continued)

If a participant does not have insurance, the participant must purchase insurance at a rate of $2 per day via the Program Charge Authorization form.

The RA should not collect any cash for any insurance fees. Instead, he/she should have the resident sign the Program Charge Authorization form. This form authorizes DHFS to charge the individuals housing bill. In addition to the Program Charge Authorization form the RA should also fill out the Request for Special Events Coverage form. Both of these form should be submitted to the Area Office at least 1 day before the event is scheduled.

*NOTE: There can be no additions to the list once it has been faxed to Student Insurance.

Travel PaperworkRELEASE AND INDEMNIFICATION AGREEMENT – Adult Student

STUDENT: UT EID: Name (last name first - please print or type)

Address

City, State, Zip Code

DESCRIPTION OF ACTIVITY OR TRIP:

MODE OF TRANSPORTATION:

LOCATION(s) of activity or trip: DATE(s) of activity or trip: FROM TO I, the above named student, am eighteen years of age or older and have voluntarily applied to participate in the above Activity or Trip. I acknowledge that the nature of the Activity or Trip may expose me to hazards or risks that may result in my illness, personal injury or death and I understand and appreciate the nature of such hazards and risks. In consideration of my participation in the Activity or Trip, I hereby accept all risk to my health and of my injury or death that may result from such participation and I hereby release the University of Texas at Austin, its governing board, officers, employees and representatives from any and all liability to me, my personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to my property and for any and all illness or injury to my person, including my death, that may result from or occur during my participation in the Activity or Trip, whether caused by negligence of the University of Texas at Austin, its governing board, officers, employees, or representatives, or otherwise. I further agree to indemnify and hold harmless the University of Texas at Austin and its governing board, officers, employees, and representatives from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in the described Activity or Trip. I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS

AND CAUSES OF ACTION FOR MY INJURY OR DEATH OR DAMAGE TO MY PROPERTY THAT OCCURS

WHILE PARTICIPATING IN THE DESCRIBED ACTIVITY OR TRIP AND IT OBLIGATES ME TO INDEMNIFY

THE PARTIES NAMED FOR ANY LIABILITY FOR INJURY OR DEATH OF ANY PERSON AND DAMAGE TO

PROPERTY CAUSED BY MY NEGLIGENT OR INTENTIONAL ACT OR OMISSION.

Date signed: 20 Signature of Student

Date signed: 20 Signature of Witness

Printed Name of Witness

Travel PaperworkThe University of Texas at Austin

Division of Housing and Food Service

REQUEST FOR TRAVEL

Attach copy of registration information and forward to Assistant/Associate Director. Also, include address to which any prepaid registration is to be mailed.

SSN: Name: OFFICIAL UT JOB TITLE (e.g., Accounting Clerk III): DESTINATION (city, state): CONFERENCE (if any): TRAVEL DATES: Start Stop Vacation dates ______________ PURPOSE OF TRAVEL (may select up to five) METHOD OF TRANSPORTATION Attend meeting, conference (01) (Division van, rental car, airplane, taxi, shuttle, etc.)

Conduct lecture or teach course (02) Participate/officiate in an event (04) Type Location (city, state) Amount

Recruit prospective employee or student (05) ____ _________ $ ____ Site or field visit (06) ___________ ________________ $______ Serve as expert witness (07) _________ ______________ $______ Fundraising (09) _________ ______________ $______ Negotiate contract (10) _________ ______________ $______ Prospective employee (11) _________ ______________ $______ Other (99) TRANSPORTATION TOTAL: $ _____ BENEFITS TO THE UNIVERSITY (may select up to five)

Enhance performance of job duties (04) Enhance University operations (05) Enhance reputation of the University (06)

Raise funds for faculty/student support (07) REGISTRATION FEE: $________ PREPAID: YES NO

Other (99) __________________________ MEALS: $______ LODGING: $_______ OTHER (GAS, HOTEL TAX, PARKING, ETC.)

$________ DISPOSITION OF DUTIES (may select up to five)

Duties assumed by colleagues/staff (02) ______________________________________

Duties require travel (03) TOTAL AMOUNT REQUESTED: $_________ Duties held until return (04) Other (99) ________________________ Signature ____________________________________ Date: ________________________________

Acct. Number: 29-0211-0075 Bldg: ______ Section: ______ Code: _______ Item No: _____ AAD Signature ______________________________________ Date: ______________________________________ VID: ______________________ DTN: __________________ RTA: ____________ DOC ID: _____________________ LODGING REQ#: H ___ REIMBURSEMENT REQ#: H_____ _______AIRFARE REQ#: H______________ HF1119 (rev 9/96)

Travel PaperworkTHE UNIVERSITY OF TEXAS AT AUSTIN

Part I. Requestor/Sponsor Information Name of University Employee Responsible for Trip: Position /Title : Administrative Unit/Organization: Phones: Office Cell Email Part II. Trip Information Purpose of Trip: Destination : Dates of Travel: Departure Return Total Number of Participants: Number of Non-Student Participants: Lodging Arrangements: Address and Phone Number Required Phone ( ) Transportation Arrangements: Vehicle: Rental Car Personal Car Van UT Owned/Leased Vehicle (circle one) Common Carrier______________ ________ Name(s) of Drivers: Name of University Employee Available for Contact in Event of Emergency: Phones: Office Home Cell Part III. Administrator Approval Required Information/Documents: List of All Participants/Emergency Contacts Release/Indemnification Agreements Proof of Medical Insurance Medical/Emergency Treatment Authorization Forms Valid Driver's License, if applicable Proof of Current Liability Insurance (For Personal Vehicle Use Only) Approval Signature Title: Date

Travel Paperwork5. Transportation

At no time may an RA transport someone to a program in his/her personal vehicle. If the RA would like to arrange for transportation, he/she may request to use funds out of the travel account. This will allow the RA (or RHC) to rent vehicles to transport residents to off campus programs.

6. Non-Resident Students Non-resident students may go on a floor trip if the following

conditions are met: a) The participant must already have insurance. b) The participant cannot use any of the University Funds allotted for the program (i.e. if the RA programming funds are partially funding $5 per participant, the non-resident student would have to pay that portion).

Travel Paperwork4. Examples

Type of Program

Release & Indemnificaton

Agreement

Request for Travel

Insurance

Program on campus (low risk

to physical safety)

No No No

Paintball, Broomball…in

Austin

Yes No Yes

Dunk Tank, Moonwalk…on

campus

Yes No Yes

Camping outside of Austin

Yes Yes Yes