Request for Corporate Travel Card

Send application to
the Controller's Office
Note: Please fill in the appropriate boxes below. This form must have your supervisor's approval and signature. After this request is approved by your supervisor, print, SIGN and add the date at Applicant's Signature and Date below. Fax signed and approved form for a new "Request for Corporate Travel Card" to: (202) 885-2839 Forms without proper signatures and authorization will not be processed.
All requests for Corporate Travel Card are subject to AU current Travel Policies and Travel Card Proceedures.
= Required Fields.

  Name:

  Social Security Number:

  Campus Email:

  Campus Phone Number:

  Department:

   Campus Address:

  Official Job Title:

  Budget Account Number:

I, , hereby apply for the corporate Travel Card to be used solely for traveling on American University's business. I understand that all charges must be according to the current travel policy at AU. Furthermore, I understand that if my request is granted, all amounts will automatically be charged to my budget account number . The bill for any charges incurred will be forwarded to me for certification after payment. It is my obligation to review those charges and return the certification within 30 days. Should I not return that certification within the specified time, I understand that those amounts will automatically be deducted for my paycheck and my card will be revoked immediately. I understand all these terms and agree to abide with them.

______________________________________________
  Applicant's Signature
     __________________
      Date Signed:

  Supervisor's Name:      Supervisor's Title: 
As supervisor of this employee, I hereby approve the issuance of a corporate Travel Card to him/her. My signature below confirms that travel is an intrinsic part of his/her duties and that the above mentioned budget account will automatically be used for all charges on the card.

  Full Time Status of employee is confirmed?   Yes No (please check one)

__________________________________________________ Date: ______________
  Supervisor Signature:

__________________________________________________ Date: ______________
Controller's Signature of Approval 

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