Center for Teaching Excellence Request for Travel Funds for Pedagogical Development Complete this form, provide all relevant information, and forward the entire application to Academic Affairs, Center for Teaching Excellence, HC1016. The Fall semester application deadline is the 1st week in October and the Spring semester deadline is the 3rd week in February. Name: School: Details of Request: Purpose: Association/Meeting/ Conference/Other: Date(s)/Location: Describe Type or Level of Participation: Total Amount Requested: Other Conferences You Plan to Attend This Year: Along with this form, please include the following information: • An estimated budget showing the distribution of costs to be incurred. • Other sources of funding with anticipated amounts. • How attending this conference will pedagogically assist you as you develop as a teacher. • Any other information that may be important in evaluating this request. Date AY2015-2016 Signature