Faculty Development | Application Form A: Conferences and Workshops

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Application Form A:
Off-campus Conferences and Workshops

Today's Date:
9/9/2026

Last Name:

First Name:

Âé¶¹´«Ã½¸ßÇå ID:

College:
 College of Aviation, Science and Technology
 College of Business
 College of Education and Social Sciences
 College of Humanities, Fine Arts and Communication
 College of Nursing and Health Sciences
 School of Graduate, Professional & Continuing Education
 
Rank:
 Professor
 Associate Professor
 Assistant Professor
 Instructor
 
Department:

Faculty Status:
 Full Time
 Half Time
 
Email:

Office Phone:

PROPOSAL

Conference/Workshop Title:

Please indicate your role in this conference. Mark all that apply to this conference:
Attendee
Session Presenter
Poster Presenter
Session Panelist
Organization Officer
Conference Committee member
Invited Presenter
Session Moderator

Indicate the type of conference this represents for your discipline:
 International
 National
 Regional
 State
 Local
 
Conference/Workshop Description: 

Dates: date format) MM/DD/YYYY

Location: (City, State and Country)

What current University initiative does this conference/workshop support:
 Student Assessment
 Service Learning
 Online/Blended Learning
 International/Global Learning
 Mission Development
 Teaching Excellence
 Research
 
Please explain the relevance of this conference/workshop to your professional development as a faculty member at Âé¶¹´«Ã½¸ßÇå University. 

BUDGET

Will any of your expenses for this conference be covered by the conference or organization that sponsors it? If yes, please enter the dollar amount)

Conference Workshop Registration and Fees:

Transportation Estimated Costs:

Airfare/Train/Bus:

Reimbursement restricted to coach/economy
Taxis/Shuttle/Uber:

Parking:

Car Mileage:


Lodging - Room Rate with Taxes:


*Generally, overnight stays for Chicagoland conferences will not be funded. Please clarify reason for overnight stay in the Chicago area.

SUBTOTAL:

 
Other Funding:
Will any of your expenses for this conference be covered by the conference or organization that sponsors it? If yes, please enter the dollar amount)

TOTAL REQUESTED:

 Subtotal - Other Funding = TOTAL REQUESTED
  
Have you submitted your Annual Faculty Report for the 2024-2025 Academic Year? (Faculty Development Funding is awarded to those faculty that have completed this report) 
 Yes
 No
 No, I am a new faculty member this academic year
 
Is attendance required for your licensure or accreditation of your program? 
 Yes
 No
 
Are students that you mentored in research/scholarship attending the conference with you? 
 Yes
 No
 

Security Password (Please type the word Âé¶¹´«Ã½¸ßÇå Password):

Note: Print this page for your records before submitting. Don't forget to submit your application after printing.


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