Request Form for Faculty Development and Research Funds

* = required field

Use this form to request additional funding needed above the amount available in your individual faculty travel account. This form is not needed when travel expenses can be fully covered by your faculty travel account.
Name:*
Email address*
Is this request for funding directly related to your faculty research?*
If attending a Conference complete section (1) below; if request is for Research activity complete section (2) below; if request is for other Faculty Development activity complete section (3) below.
(1) CONFERENCE INFORMATION
Conference Attending
Conference Dates
Location
If presenting, title of presentation
Has paper been accepted?
(2) RESEARCH PROJECT
Explanation of Research Project
Project Dates
Location
(3) OTHER FACULTY DEVELOPMENT
Explanation of Faculty Development
Dates
Location
(4) ESTIMATED COSTS
Airfare
Lodging
Registration Fees
Vehicle Costs (college vehicle or mileage reimbursement $.32 per mile)
Car Rental/Taxi
Parking
Research Supplies
Other
(5) FUNDING AVAILABLE
Faculty Travel Funds
Other Funding
Will you receive a stipend, honorarium, royalties or other income for this presentation or activity? If so, indicate amount below:
Tarbabypre
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Tarbaby
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Noturl
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Antlion
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