University of Pittsburgh Cancer Institute (UPCI)

Policies and Forms

UPCI Travel Request Form

  • Use this form for:
    • All international travel.
    • Any travel within the United States for which you may be requesting UPCI funds* to cover all or a portion of the expenses.

      *UPCI funds include all funds other than grants, contracts and sponsored programs. They include hard funds, restricted funds (including Hillman Foundation funds, which cannot be used for travel), discretionary funds, start-up packages, and other UPCI commitments of support.
    • The Office of the Director of UPCI has the responsibility to approve all expenses from UPCI funds. The Office of the Director of UPCI also reserves the right to disapprove inappropriate or excessive use of funds from all other sources, including excessive travel without acceptable justification.
  • PLEASE PROVIDE AT LEAST 10 BUSINESS DAYS NOTICE TO PROCESS THIS REQUEST.
  • Prior to completing this form, please review the UPCI Travel & Business Expense Reimbursement Policy (REVISED).

Instructions for Completing and Submitting Form

Submit the completed form and supporting documentation as follows:

  1. Online Submission of Form:
    • Please complete Sections I-IV.
      • Note:
      • For Supporting Documentation in Section IV, you will be asked to provide URLs for the conference web page, and meeting brochure or flyer. If there is no online information available, you will need to submit scanned or hard copies of conference information (see Item 2 below).
    • Click 'Submit' button at bottom of completed form.
    • You will be asked to confirm your information before final submission. To make changes, click the back button on your browser window, make changes, and click 'Submit' again.
    • When all information is correct, click 'Submit Confirmed Copy'.
    • After submitting form electronically, you will receive a .pdf file of your completed form. Save this file to your computer. You may need the .pdf to submit with hard copies of your supporting documentation.
      Note:
    • Approvals in Section V are not the applicant's responsibility, but this page will be included with your submission.
  2. Submission of Supporting Documentation: Please submit supporting documentation using one of the following methods:
    • Online Form (preferred): In Section IV of the online form below, provide URLs for the conference web page, and/or meeting brochure or flyer.
    • -OR-

    • E-mail submission: If you have only hard copies of the supporting documentation for the conference/meeting, please scan the information and e-mail the .pdf of your completed form and all scanned documents as attachments to:
      Alison Lithgow at lithgowap@upmc.edu
      Subject line: Travel Request for [your name]
    • -OR-

    • Hard copy submission: If supporting documentation is available only as hard copy and you are unable to scan, please print your completed form (the .pdf document), attach a hard copy of supporting documentation, and send/deliver all pages to:

      Alison Lithgow
      Shadyside Place
      Suite 100
      580 S. Aiken Avenue
      Pittsburgh, PA 15232
  1. General Information
  2. First Name:
    Last Name:
    Email:
    Phone Number:
    PI of Laboratory you are affiliated with (if applicable):
  3. Travel/Conference Details
  4. 1. Name of person traveling:
    2. Dates of travel:
    Date Picker
    Depart
    Date Picker
    Return
    3. Reason for trip, including name and location of conference/meeting
    a) Reason for travel:
    300 characters remaining
    b) Conference name:
    c) Conference location (City/State/Country):
    d) Conference/Meeting Dates:
    Date Picker
    Start
    Date Picker
    End
    4. Estimated costs
    a) Hotel: $
    b) Registration: $
    c) Travel (airfare, mileage, car rental, etc.): $
    d) Meals/Per Diem: $
    e) Other: $
    f) Other Description:
  5. Section III: Funding Source
  6. Available sources of funding (Please provide complete information for all lines that apply):
    Grant Funds: You may select up to three grant funds
    Grant 1:
    Yes

    No
    Account number:
    $ Amount or % of Funds:
    Grant 2:
    Yes

    No
    Account number:
    $ Amount or % of Funds:
    Grant 3:
    Yes

    No
    Account number:
    $ Amount or % of Funds:
    UPCI Funds*:
    Start-up/Other UPCI Commitments:
    Yes

    No
    Account number:
    $ Amount or % of Funds:
    Discretionary Funds:
    Yes

    No
    Account number:
    $ Amount or % of Funds:
    Restricted Funds:
    Yes

    No
    Account number:
    $ Amount or % of Funds:

    *Notes:

    • Hillman Foundation funds cannot be used for travel.
    • The Office of the Director of UPCI has the responsibility to approve all expenses from UPCI funds. The Office of the Director of UPCI also reserves the right to disapprove inappropriate or excessive use of funds from all other sources, including excessive travel without acceptable justification.

    Section IV: Supporting Documentation

    Please provide URLs for the conference web page, and/or meeting brochure or flyer. If there is no online information available, you will need to submit scanned or hard copies of conference information as described in the instructions.

    URLs for conference/meeting information:
    HTTP://