EmailMe Form - REPORT ON TRAVEL FUNDS AWARDED

Name

First Last

Phone Ext.

Discipline/Classified Department

Application Submission Date

MM / DD / YYYY

Conference Date

MM / DD / YYYY

Conference Title

Conference Location

Funds Requested

$ Dollars

Funds Awarded

$ Dollars

Please submit this form within 10 business days of your return to campus at the conclusion of your conference. Failure to submit this form in the specified time could jeopardize your consideration for future conference and travel funding

Please submit a written report of the conference attended providing the information requested below. This information will assist in the development of required reports and planning for staff development/ Flex activitities. Thank you.

Did the conference meet the goals stated on your application?

Yes

No

Do you recommend this conference to your colleagues?

Yes

No

Describe how this conference contributed to your professional learning and/or improvement of instruction in the classroom.