Travel and Leave Authorization Dean’s Office Travel and Leave Request "*" indicates required fields Name*Amanda PhelpsChristina PerezJean SweitzerKaren RhodenizerRichard MillerDr. Ana Dias RibeiroDr. Alex DelgadoDr. Cal DolceDr. M. Franklin DolwickDr. Joseph RileyDr. Marcio GuelmannDr. Pamela SandowDr. Daniel McNeilDr. Patricia PereiraDr. Patricia Xirau-ProbertDr. Roberta PileggiDr. Valeria GordanDr. Shannon WalletDr. Panagiotis ZoidisDr. Anita GohelDr. Wagner DuarteDr. Roger FillingimStephen KostewiczEmail* Additional email to receive copy of request (i.e. dept. admin) Type* Vacation Sick Business Travel Other Description of "other" type of leave or if you are requesting multiple types of leave, please specify dates for each type:Beginning Leave Date* MM slash DD slash YYYY Ending Leave Date* MM slash DD slash YYYY Total Number of Hours*Outside Activities and Conflicts of Interest Requirements*All external professional activities, compensated or uncompensated, must be disclosed by completing the Outside Activities and Conflicts of Interest process, even when using personal leave. If this disclosure was required, has it been submitted to HR? N/A, this request does not require an Outside Activities Disclosure. Yes No Business Travel InformationType*Conference/Convention/MeetingSpeakerOtherDescribe travel (location/dates/benefit to UF):*Emergency Contact InformationActing Dean or Chairperson*Office Phone*Cell Phone*Additional Information/CommentsPlease do not include confidential information here.
