Faculty Development Fund Request Form
For travel completed between 7/1/18 and 12/15/18
Today’s Date:
Name: Academic Rank:
Department/Division: School/College:
Name of Event:
Nature of Your Participation (attendee or presenter):
Location of Event:
Dates of Travel:
R
espond to the category below to which your request applies:
1. If you received funding last academic year, please state where and when your (1) paper was submitted to what journal and/or
(2) activity performed and/or, (3) work was displayed and/or adjudicated
:
2. Title of paper/activity and intended publication/adjudication for current academic year’s request:
3. Name of academic association and office held related to event (if applicable):
4. W
hat do you hope to gain by attending this event:
Estimated Budget
Approved by:
Division Chair: Date:
Dean: Date:
Amount approved $ Date:
Academic Affairs: Fund:
Or - Personal auto @ miles @ 54¢ (up to 400 miles roundtrip) Rental car must be
used if more than 400 miles R/T. Include MapQuest for all travel
Lodging at $ per day X days
Meals (for estimation purposes)
Other expenses (i.e. poster printing, taxi)
