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Worker Travel & Tour Request Form
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For Workers returning to the U.S. and traveling during Home Assignment.
Name
Field
Region
Today’s Date
Air Travel
Field Departure
 Departure City
Departure Date
Home Arrival
City
Arrival Date
I/we are taking vacation time at the beginning of HA.
YES    NO
Begin Date
End Date
Do you have return tickets to the field?
YES    NO
If yes, please complete the following information:
Return Information
Departure City
Departure Date
If not a direct flight, please list stopover points and dates:
Do you need IM to process visas before returning to the field?
YES    NO
Home Assignment Address
Address 1
Address
City
State
Zip Code
Date Beginning
Date Ending
Phone
Email Address
Cell Phone
Address 2
Address
City
State
Zip Code
Date Beginning
Date Ending
Phone
Address 3
Address
City
State
Zip Code
Date Beginning
Date Ending
Phone
*If you have any additional addresses, please fill those in the ‘Additional Comments/Addresses’ box at the bottom of this form.
Emergency Contact
For the Worker
Contact Name
Address
City
State
Zip Code
Email Address
Home Phone
Office Phone
Cell Phone
Relationship to Worker
For Worker’s Spouse (if different than above)
Contact Name
Address
City
State
Zip Code
Email Address
Home Phone
Office Phone
Cell Phone
Relationship to Worker
Finances
Allowance(s)
Do you want your allowance deposited to your bank account?
YES   NO
Please contact International Accounting if your banking information needs to be updated: intlaccting@cmalliance.org
Rent (not automatic)
Start Month
  Amount
Comments
Fall and Spring Conference Tour Request
Home District
For the Worker
What district would you like to tour for the FALL?
What district would you like to tour for the SPRING?
For Worker’s Spouse
What district would you like to tour for the FALL?
What district would you like to tour for the SPRING?
*Additional
Comments/
Addresses