Noyce Scholars - TEMS II
Professional Development Travel Funds Request Form
Please submit this written request responding to the four areas below. The entire request
should not be much more than one page in length. This request must be submitted at least
five weeks before the conference you wish to attend.
Name of PD Participant:
1. The Conference: State the name of the conference, the name of the sponsoring
organization, as well as the dates and location.
Conference Information:
Name of Conference
Date(s) of Conference
Sponsoring Organization
Location of Conference
2. Your Participation: Describe how you intend to participate in the conference. If you are
presenting, include the title and nature (talk, poster, etc.) of your presentation.
(type response here)
3. The Benefits: Describe the importance to your professional development as an educator
and the benefits to the CSU Chico Noyce Scholars Program.
(type response here)
4. Budget: See the example below. If you need funds that are not in any of the listed
categories, include a brief justification. All receipts must be kept in order to receive a full
reimbursement for travel.
Estimated Expenses:
Expense
Description
Amount
Transportation
Airfare or vehicle mileage ($ per mile)
Lodging
$$$ per night for X nights
Registration
Meals
($ per diem??)
Total