(Continuing and Global Education Use Only)
Fall Winter Summer Spring Year____________
Total Amount Approved _____________________________
Amount per Student ________________________________
Number of Students ________________________________
REQUEST FOR TRAVEL GRANT FUNDING
FOR INTERNATIONAL PROGRAMS
Faculty Name: ________________________________________________________________________________________________________________
Last First Middle Initial
Fresno State ID:___________________________________________ Telephone: _________________________ Email: ____________________________
(Ofce)
Campus Department:_____________________________________________ Mail Stop ____________________________________________________
Faculty Leader Information
Grantappliedtowardsstudents’programfees
Other ____________________________________________________________
Please describe the program and activities the students will undertake:
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
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APPROVAL SIGNATURES
Faculty Leader: ____________________________________________________________ Date: _______________________________
Approved by Department Chair: ______________________________________________ Date: _______________________________
Approved by Dean of School/College: _________________________________________ Date: _______________________________
CGE Ofce Use Only
Date Received: ________________________________________________________________
Travel Grant Coordinator: __________________________________________________ Date: ______________________________
Manager of Finance & Administration: _______________________________________ Date: ______________________________
Program Name: _________________________________________________ Program Fee: ___________________________________
Comprehensive Program Dates: ____________________________________ to ____________________________________________
HostCountryandCityLocation(s): _________________________________________________________________________________
Deadline for Students to Apply for the Program (if known): _______________________________________
Is Academic credit to be provided?
es _______units
No Travel Warning?
es
No Approved by CGE?
es
No
Has this program received funding from IRA or Travel Grant programs in prior years?
No
es If yes, please describe:
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
How many Fresno State students are expected to participate in this international program? Minimum __________ Maximum __________