RANDOLPH COLLEGE

Teaching Conference Funding Application

Name of Applicant:  _______________________________________   Date:  ________________

Name of Conference: ___________________________________

or

Name of Speaker: ______________________________________

    Name of Teaching Workshop: ___________________________

Dates for conference or speaker:

            from  ____________________ to  ____________________

Location(s) where project will be carried out:  

_________________________________________

Describe below the conference you wish to attend and what you hope to accomplish at the conference. Or, describe why you wish to invite the speaker for the teaching workshop and for whom the workshop is appropriate. Please submit a descriptive brochure for the conference or the speaker, if possible, with your application. A c.v. for invited speakers should be included with your application.

Please type or print legibly in ink

Name:_______________________________________                         
page2

Budget

For a speaker:

                                                           Enter requested honorarium amount here:     __________

                                                                                     and any additional fundings below.

For Teaching Conference Funding:

                                                                                List the projected budget amounts in the first column below.

(A copy of this budget page will be returned to you with the notification of approval of your grant. When you have completed your project, enter the actual expenses in the second column of the copied budget page and return to the Faculty Development Coordinator.  Any unused funds from the grant should be returned to the Business Office.  Receipts should also be turned in to the Business Office; if receipts are not submitted, grant funds must be considered income and taxed accordingly.  Expenses beyond your projected budget will, upon request, be considered for reimbursement by the Faculty Development Coordinator Advisory Committee.)

                                                                                                                                Projected Budget        Actual Expense

Transportation

     Commercial Fare:  ___  Air  ___  Bus  ___  Train                           __________                              __________

     Travel to and from Airport or Station                                               __________                             __________

     Private Car:  _______ miles r/t @ .50                                                __________                             __________

Subsistence

     Lodging:  $__________ per day x _____ days                              __________                            __________

     Meal Allotment:  $50 per day x _____ days                                   __________                              __________

                (Accounting for actual meals is not required.)

Other Expenses

     Registration Fee                                                                                 __________                               __________

     Conference Materials                                                                        __________                               __________

     Local Transportation                                                                         __________                               __________

     Other (please identify:  ____________________ )                     __________                              __________

Total Amount Requested                                                                      __________

                                                Total Actual Expenses                                                                                  __________

If you do not otherwise plan to use the $525 annual travel stipend

provided by the College, subtract the available balance here:                         -  __________                - __________

                                Adjusted Amount Requested                                                 __________

                                                                Adjusted Actual Expenses                                                                 __________

Unused Funds Returned                                                                                                       __________

August, 2007