Full-time Faculty and Staff Travel Assistance Request Form Webform July 16, 2018 Complete all information below. Personal Name: * Rank: * Email Address: * Confirm Email: * Reason for Request (ranked) Select One: * Giving a paper which will be published in refereed proceedings Presenting a paper (or session for non-research faculty) Participating in a formal capacity Professional development (for staff) If you indicated option #3 "formal capacity" please specify the role: Conference, Location, Dates Name of Conference: * Location: * Departure Date: * MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031 Year20222023202420252026 Return Date: * MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031 Year20222023202420252026 How will your classes/duties be handled in your absence?: * Additional Information for Director: * Note: Where the School has an exhibit, please assist with staffing; where the School is sponsoring a reception, please attend. Funding Check all that apply. Funding to Cover: Airfare Lodging (up to $333 per night, tax excluded) Registration Meals Other No Funding: require authorization No Funding: paid by self No Funding: paid by 3rd party (specify below) If other specify: If you selected “Other” for partial funding, please specify. Third party specify: If expenses to be paid by third party, please specify.
