Form and supporting documents MUST be submitted electronically as ONE document.
Name: ____________________________________
Date: ____________________________
Department: ____________________________
Phone Ext.: _________________
FT
PT
Name of Conference or Development Activity (include the name of the sponsoring organization):
Dates of Attendance: _____________________________________________________________
Location: ______________________________________________________________________
Please attach a brochure or meeting announcement. If you are applying for funds at Level 1 or 2, you
must also enclose further supporting documentation.
Please indicate the nature of your participation:
Level 1 - 100% Presenting original work for the first time.
First time presentation can be in the form of oral, poster or other accepted means of presentation at a
recognized conference in the field.
Title: _____________________________________________________________________________
Please attach an abstract (in English) and, if possible, a letter of acceptance from the conference
organizers. Before you are reimbursed, you must also submit a copy of the paper itself. If your
presentation did not involve a formal paper, you must submit a summary of your presentation and a copy
of the program.
Level 2 75%
Please indicate the basis for your funding request. Please attach supporting materials.
__________________________________________________________________________________
Level 3 60% of the amount up to $500, 50% of the amount over $500
All Level 3 requests will be held for review at the March meeting of the FDC and will be awarded based
on the availability of funds.
Faculty Conference and Travel Fund Request 2020 2021
The applicant is expected to find the most economical rate for travel and lodging before filling in the
following information. FDC reserves the right to limit travel, food and/or lodging budgets.
Travel: Plane/train/bus fare: $ _________________
Mileage @ $.58/mi: $ _________________
Parking $ _________________
Food: $ _________________
Receipts must be submitted in order to receive food reimbursement. Your expenses will be reimbursed
for actual expenses. When conference registration fees include meals, please adjust the daily
expenditures accordingly. Please refer to the College reimbursement and credit card policy.
Lodging: $ _________________
Registration: $ _________________
(Reimbursement applies to conference/registration fees only, not membership dues.)
Other: $ _________________
Please explain: __________________________________________________________________
TOTAL: $ _________________
How much funding have you received during this FISCAL year (7/1/20 - 6/30/21)? $ ______________
For summer requests only: Do you plan to return to your faculty position at Hood in the coming
academic year? Yes No.
To receive funds, a faculty member must be under contract to the College, and in the case of summer
funding, a faculty member must be under contract for the following academic year.
In no case will a full-time faculty member receive more than $1,000 or a part-time faculty member receive
more than $500 in one FISCAL year.
Please send completed form and supporting materials electronically (as ONE document) to the Faculty
Development Committee, c/o Julie Chalk, Provost’s Office, chalk@hood.edu.
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