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Tennessee Technological University
Request Form for Professional Development Support from Faculty Development Fund
NOTE: If you are presenting use the Travel Support Form.
Please fill in all sections and check appropriate boxes. Incomplete forms will be returned. Your
department chair and college dean must sign this form in section 5. The college dean’s office
should submit the completed form to the Office of the Provost, attn. Faculty Development Fund.
1. Requester Details
Name: Last First
Email: Phone:
Faculty Rank: Professor Associate Professor Assistant Professor
Tenure-track/Tenured Instructor Lecturer
College:
Department:
Title of Activity:
Description of Activity:
Sponsoring Organization:
Website URL:
Location (City/State/Country): City State Country
Dates for Activity(MM/DD/YY - MM/DD/YY):
-
*You are also encouraged to attach brochures, flyers, or other information regarding the
professional development activity/event.
2. Professional Development Activity Details
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On a separate (attached) sheet, please provide a statement that specifically explains of how
the proposed activity will contribute to your professional development and supports the
mission of your department/discipline, college, and/or the university. This statement
should be 250 words or less.
Please provide a cost estimate of your trip:
Registration Fee
$
Other incidentals (please describe)
Economical Airfare
$
Ground Transportation
$
Lodging
$
Meals
$
Miscellanies
$
TOTAL
$
Required Signature
Faculty Member Date
Department $
College $
Approved by: Signature:
Grants $
Approved by: Signature:
Others (please
specified)
$
If you have any questions, please contact Associate Provost, Dr. Sharon Huo, at xhuo@tntech.edu.
The Provost’s Office will notify the college of the funding decision.
3. Statement of Purpose
4. Travel Cost Estimate
5. Support from Other Sources
Used by the Office of the Provost