Faculty Travel Fund

Faculty Travel Fund_original

Last Name *

First Name*

Email*

Title *

School *

Program *

Conference Name *

Organization Sponsoring Conference (Please spell out the full name of the sponsoring organization.) *

Dates of Conference *

Location of Conference*

City

State/Province

ZIP / Postal

Country

Are you presenting

Yes No

Include the title of the presentation, if applicable.*

What is the relevance to your teaching/research activities at Mercy University? *

Is this activity supported by your Chair/Program Director?*

Yes No Not yet discussed

Estimated Costs

What is the total (estimated) cost of attendance? *

Please indicate the total amount you are requesting. *

Registration cost

Airfare

Lodging

Ground transportation

Meals

Other expenses

Have you been approved/reimbursed for travel between July 1, 2024 - June 30, 2025?*

If yes, please indicate the amount for which you were previously reimbursed.

Notes

e-signature *