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CALIFORNIA STATE POLYTECNIC UNIVERSITY, POMONA
PRE-APPROVAL FOR TRAVEL FORM
This form is intended to be an initial assessment for pre-Approval to travel effective June 1, 2021. Caution should be
maintained and in alignment with local health orders, and the health orders of the destination of travel. Travelers should
complete this form to submit to their HEERA manager (approver for Travel) for review and approval. If the HEERA manager
approves the request, it will be submitted to the Vice President for review and final determination. If the Vice President
approves the travel the approval may be revoked at any time pending changes to circumstances of the Pandemic. Travel
should be limited to essential travel for faculty research activity, conference presentations, and other Cal Poly Pomona
mission driven work.
Once pre-approval has been obtained, the Travel process within Concur will need to be followed and a copy of
this Approved form will need to be attached to the Travel Request and Expense Report.
Name of Traveler Today's Date
College Department Division
Destination Traveling By (Air, Auto, etc.)
International Travel: Centers for Disease Control International Travel: United States State
Warning Level for Country - Attached Department Travel Advisory Status - Attached
Reviewed Local Health Orders (Travel Destination) Reviewed Local Health Orders (Home/Campus)
Purpose of Travel:
Start Date of Official State Business End Date of Official State Business
Does this trip contain personal travel? Yes No
Start Date of Personal Travel End Date of Personal Travel
____________________________________________
Comments:
HEERA Manager Name / Signature / Date
____________________________________________ Comments:
Travel Request Approver Name / Signature / Date
Approved Denied
Comments:
____________________________________________
Vice President Name / Signature / Date
05/2021


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