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K:\Shared Goodies\Forms\Travel Request Form January 2010
NAME(S) AND POSITION(S): DATE:
NAME OF CLASS / MEETING: DESTINATION:
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
PURPOSE OF TRAVEL/TRAINING:
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
LODGING TAXI GRANT REIMBURSABLE
MEALS PARKING YES NO
REGISTRATION AIRFARE REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
I APPROVE THIS TRAVEL REQUEST
DEPARTMENT HEAD MAYOR
DATE DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED
FY ____ BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original – Clerk/Finance Copy – Department
TRAVEL REQUEST
CITY OF WATERLOO
010-09-8250 1315
7,950.0027
4,075.00
2,350.00
1,525.00
10/2/26
Nikki Fischels, HR Specialist 9/23/2026
Grow Cedar Valley- CVLI
10 classes between 10/6/26 &
6/2/2027
10 classes between 10/6/26 &
6/2/2027
10 classes between 10/6/26 &
6/2/2027
and civic responsibilities shaping the Cedar Valley.
x
x
010-09-8250-1315
x
2350.00 x
2350.00 2350.00
Lance Dunn
9/23/2026
community leadership by giving participants a broader understanding of the opportunities, challenges
To attend the Grow Cedar Valley's Leadership Institute (CVLI). CVLI is designed to strengthen
Waterloo, IA
Docusign Envelope ID: 9AE04D1C-71CB-8FF3-80F2-97C7E76B2C98
10/05/2026
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