Traveler Information Form – Enrollment Services

Please help keep records for travel up to date!

Name * Required
Please enter your **FULL LEGAL NAME** exactly as it appears on your government issued ID/ Driver’s License
First Middle Last
Email * Required
Department * Required
Which of the following modes of transportation will you use? * Required
Please select all that apply.
- Select All
- Personal Vehicle
- Flights
- Rental Vehicle (e.g. Enterprise)
- Leased Vehicle (DES Motor Pool)
- Other (please describe below)
Other * Required
Please enter the additional form of transportation
Home Address * Required
This will be used for calculating mileage when necessary

Street Address Address Line 2 City State ZIP Code
Date of Birth * Required
Required for reserving flights.
Month
Day
Year
Cell Phone Number * Required
Required for flight and vehicle reservations.
Flight Seating Preference * Required
Please select your seating preference (every effort will be made to accommodate your request; dependent upon availability)
- Window
- Aisle
- Middle (when available)
Driver's License Number * Required
Will be used to locate rental agreements and receipts when necessary.
Driver's License Date of Expiration * Required
MM slash DD slash YYYY