BHWDTravel Request Form

BHWD

Travel Request Form

For any in-state travel requests, complete and submit this form PRIOR to booking travel as a thorough review process is required by AHP. This is mandatory for all travel booked within this grant period. Your Grantee Coach will follow up with you regarding AHP approval and clearance to book travel.

Notice: Out of state travel is not permitted with this grant program.

Submission Date*

Submitter's Name*

Submitter's Email*

Grantee Coach*

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Project Name*

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Was this travel expense approved in your Phase B Budget?*

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Organization*

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Unique ID

Start of Travel Date*

End of Travel Date*

Number of people participating in travel*

Purpose of Travel*

Are you requesting AHP approval for travel that has already occurred in this grant period?*

For approval for past travel bookings, please upload all travel-related documents including hotels reservations, meals, and mileage via the File Upload at the end of this form.

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Is an overnight stay at a hotel required?*

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Is the hotel you found within state guidelines?*

Use this link to find out if the hotel rate falls within the maximum lodging reimbursement rates per night allowed by the state of CA.

https://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx

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Can suitable accommodation within the state rate be found in the location you require?*

Exceptions can only be made for situations in which a hotel or other suitable accommodation cannot be found under the maximum allowed state rate provided in the link above.

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What is the hotel rate per person per night?*

Please complete the Excess Lodging Rate Approval Request Form linked below and use the file upload at the bottom of the form to attach and submit.

If suitable accommodations cannot be found below the stated rates, you may submit the Excess Lodging Rate Approval Request Form to your Grantee Coach, https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std255C.pdf which must be approved by AHP before the trip occurs or costs are incurred.

File Upload

Use this upload to attach any relevant travel documents or required forms. (i.e. past travel bookings, current hotel rates, Excess Lodging Rate Approval Request Form (if required), etc.)

Drag and drop files here or

Please provide additional details for AHP approval.*

We need to know the names of the individuals who are traveling and their employment status (e.g. where and who, AHP, etc.).

Send me a copy of my responses

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