Fillable EPICTS Formfinal83 (Jacksonville University)

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EPICTS Formfinal83 (Jacksonville University)

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ORSP: TS – EPIC Professional Development Application - V. 8/31/2018
2018-2019 Travel Support
EPIC - Professional Development
Application Form
Instructions: Please be sure to read the Travel Support EPIC Professional Development
Guidelines posted on the ORSP webpage. Complete this fillable form and forward along with any required
attachments to EPIC@ju.edu before 5:00 pm EST on the second Monday of the month. Travel
Support requests must be submitted at least four (4) weeks prior to the departure date, and six weeks
prior if traveling out-of-state. Award decisions are returned no later than the last day of the month the
request was submitted. Any proposal received after a deadline listed below will be considered during the
following month’s cycle.
2018 Deadlines: September 10 October 8 (Tuesday) November 13* December 10
2019 Deadlines: January 14 February 11 March 11 April 8 May 13
*Monday, Nov 12 is Veterans’ Day
I. Travel Support Request
Participation Purpose (check one): Attendee Presenter
II. Faculty/Student Information
Name: Academic Rank/Year:
Department/Major:
JU Email:
III. Travel Details
Conference
Title
Presentation
Title
, if applicable
Destination
Dates of
Conference
Start Date
End
Date
Departure
Date
Return
Date
Amount of
Funding
Requested*
*Per-trip MAXIMUM:
$1,000 for attending $1,500 for presenting
Original receipts required for reimbursement.
JU & FDOE Travel Policy/Procedures apply.
SIGNATURES - Electronic or hand-written signatures are acceptable.
Student:
Dean:
Required Attachments: Attendee applicants submit completed form and the conference agenda (PDF,
screenshots, etc., but please no links). Presenter applicants submit completed form and presentation
abstract. For reimbursement, all awardees must submit original receipts, a copy of the conference
program and, if they presented, evidence of acceptance via letter/email. If traveling out of state, this
completed FDOE request for approval form must be attached.
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Completed 21 July 2020

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