1
Tennessee Technological University
Request Form for Travel Support from Faculty Development Fund
NOTE: To be eligible, you must be the person who actually delivers the presentation.
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 Conference/Meeting:
Sponsoring Organization:
Meeting Website URL:
Location (City/State/Country): City State Country
Dates of Meeting (MM/DD/YY - MM/DD/YY):
-
Is this a regularly occurring meeting (annual, semi-annual, etc.)? Yes No
Is this a meeting of a state, national or international conference?
State National International
Title of Presentation:
Type of Presentation: Paper Poster Performance Other(Specify):
Has your abstract, paper, or presentation been accepted? (Attach documentation)
Yes No
2. Conference/Meeting Details
3. Presentation Details
2
Are you the presenter? Yes No
Co-Authors (if any) and their affiliation:
Please provide a cost estimate of your trip:
Registration Fee
$
Other incidentals (please describe)
Economical Airfare
$
Ground Transportation
$
Lodging
$
Meals
$
Miscellanies
$
TOTAL
$
NOTE: Please print completed form and obtain appropriate signatures. Attach documentation
indicating that you have been accepted as a presenter and the conference / meeting information
or brochure.
Required Signature
Faculty Member Date
Department/
School
$
Comments:
Approved by: Signature:
College $
Comments:
Approved by: Signature:
Grants $
Comment:
Approved by: Signature:
$
Comments:
Approved by: Signature:
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.
4. Travel Cost Estimate
5. Support from Other Sources
Used by the Office of the Provost