UC Business Travel
Asterisks (*) indicate required fields
This form is designed to provide the University with information about travel by UC employees and affiliates for risk management and to provide the traveler with insurance coverage information and travel tips. If you are planning a research/field trip, we will have a Field Safety Plan generator available soon.
    Call technical support at (415) 437-3980 if you have any technical problems with this form. Examples include:
  • You can not save or submit the form
  • You can not print the Travel Assistance and Insurance ID card after saving the form


Primary UC Traveler
First Name*Last Name*
Email while traveling*Other Email
UC ID#
Category of the Primary UC Traveler*
Purpose(s) of Trip*
Research
Academic Instruction
Training
Public Service
Clinical Service
Organized Recreation (Outdoor Adventures)
Other
Administrative Activities
Study through UCEAP
UC Location*


Persons accompanying the primary UC Traveler on a UC business trip
(If you are traveling alone, skip this table)
Number of accompanying Persons
Add Additional Travelers in the same category
One name per line; for example:
John Doe
Jane Doe
Trips with both students and employees need complete this form twice, once for each group


Nearest airport to city where travel originates from*
Lookup
Travel Start Date*
End Date*
Origination City Code


Anticipated Schedule of Foreign Travel (Required of all travelers leaving the US on UC business)
Travel originates outside of the USA
Primary Destination (Country) (Updates City and Airport Code) Primary Destination (City) Airport Code Visit Start Date Visit End Date Mode of Travel
Add another destination


Anticipated Schedule of Travel within the United States
Travel originates outside of California
Primary Destination (State) (Updates City and Airport Code) Primary Destination (City) Airport Code Visit Start Date Visit End Date
Add another destination
Submit