LIDS Travel Reporting Form -- Admin: Shyla

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students/Postdocs/Visitors supported by Bresler, Ozdaglar, Shah and Wilson.

This Google Form collects information about the purpose of your travel, the details of your itinerary and its costs. Please submit legible PDF's of all your receipts by EMAIL to Shyla (putrevu@mit.edu).

You will receive an email receipt of this submission with a link to edit. Please use the link to edit responses. Do not submit a new response for the same trip.

If you have any problems or need assistance, please feel free to email me at putrevu@mit.edu.

Thank you!
- Shyla

Email *

1. First Name and Last Name of Traveler *

2. Traveler Type *

Grad student, postdoc, visitor (please include the name of host institution), etc.

3. Date Trip Started *

4. Date Trip Ended *

5. Destination *

6. Trip Justification

1. Name of Event Attended [conference or workshop; company visit (mention host’s name); meeting, etc;]

2.. Research objective accomplished (see example below). Please include brief description of activity

Example:

1. NSF Workshop on Cyber-Physical Systems.

2. Presented work done on this project, related to power grid vulnerability.

The title of my work was "Robustness of Cyber-Physical Interdependent Networks".
The workshop presented me with an opportunity to interact with researchers in the field and publicize work under this project.

7. Faculty Research Supervisor *

8. Expenses -- Large Transportation

Example: Flight $316.60; Train $124 [not taxis].

If the flights are not direct (i.e. BOS<->DESTINATION), please provide estimated cost of direct flights along with actual flights.

9. Expenses -- Small Transportation

Example: Taxi, 6/14, home to airport: $35; MBTA, 6/11, airport to home $2

10. Expenses -- Hotel/Lodging

(receipt can include incidentals like internet, parking and meals charged to hotel bill.)

Example: Hotel (4 nights - June 14 - June 18): $432.00

11. Expenses -- Food/Meals

Example: June 14 $ 55; June 15 $ 42 and so on. (do note alcohol is NOT allowed)

Please email legible itemized receipts to Shyla . Meals can now include in-transit meals in airports.

12. Expenses -- Other

i.e. Conference Registration Fees, Car Rental or Personal Vehicle Mileage, Parking, Gas, Tolls, Posters, Baggage, Telephone/Internet, Visa/Passport/Consulate Fees & Postage, Required Vaccinations, Finance Charges on Foreign Transactions, etc.

13. HOME ADDRESS (for guests who reside in the U.S) *

For Travel Reimbursements, checks are mailed to your U.S. home address.

Please provide your mailing address OR type in "N/A" if not applicable.

14. WIRE TRANSFER Information (for guests who reside outside of the U.S.)

If you live outside the U.S., the Reimbursements are made via a Wire Transfer.

Please provide the following information OR type in "N/A" if not applicable.

(1) Account owner/recipient name:

(2) Bank name:

(3) Bank address:

(4) Account number:

(5) SWIFT code (or the preferred banking network code in your country):

A copy of your responses will be emailed to the address you provided.