Faculty Travel Request Form: 2013-2014 (7/1/2013-6/30/2014)
Submitted by:
Date of Submission:
Name of Organization/Conference:
Location:
Dates:
Nature of participation
(Check all that apply):
____
Presenting at the conference
(e.g. panel discussion, poster session, etc.)
____Presentation acceptance(s)/invitation(s) received (please attach a copy of the confirmation)
____Planning for/anticipating submissions & acceptances of convention papers, proposals, etc.)
____
Receiving faculty award OR receiving student award as faculty advisor
____
Chairing/Moderating a session
(please list the session you are committed to chair/moderate)
____
Serving as organization/conference officer and attending business meetings
(please specify your officer title and responsibility)
____
Other
(please specify and provide supporting document)
Approximate cost of travel (provide breakdown, if possible, for airfare, registration, etc.)
Airfare/Rail/Personal car:
Registration:
Meals (per diem rate if faculty/staff):
Lodging:
Other:
Total travel request:
Source and amount of funding requested
(Check all that apply):
____School travel fund
____Faculty start-up (tenure-eligible faculty only)
____Grant (please specify)
____Other (please specify)
Does the organization/conference provide any funding support for the following?
(Check all that apply):
____Yes (If yes, please list the amount for each of the following):
_____transportation ____lodging ____registration ____ meals
____No
School Review Notes
Review date:
Review decision:
Comments: