Request for Financial Support

Professional Development Fund

Request for Financial Support

Name(s):

Date:

Campus phone:

E-mail:

Date(s) of activity:

Location of activity:

General purpose of your activity (please check one or more):

Activities eligible for 100% funding:

____to present a paper or poster at a conference

____to attend a conference, workshop, or mini-course for accreditation

____to conduct research activities

____to perform an artistic work

____to maintain professional credentials, i.e. required licensing, workshops, & continuing education

Activity eligible for 50% funding:

____to attend a conference, workshop, or mini-course

____to learn about emerging technologies

____to learn about program administration

____to enhance teaching skills and ability

____other (describe)

Other (funding level TBD)

Please explain:

Note: Proposals may be resubmitted after April 1st for further funding consideration! Proposer may also contact the DAA independently to seek additional funds, or seek funding from another source outside the campus.

Please complete the application on the following page and submit according to the instructions provided in the Professional Development Fund Instructions document.

Anticipated Budget

$__Registration fee

$__Mileage (miles at $.565 per mile, or current rate at time of proposal)

$__Tolls

$__Parking

$__Meals (actual expense, if known, or per diem from ERS. Note that if meals are included in conference registration, per diem must be pro-rated accordingly.)

$__Airfare

$__Train Fare

$__Taxi

$__Hotel ( nights at per night. Note that if the room will be shared, expense listed should be actual cost per person. Tax should be included.)

$__Other (please explain.)

$______Total estimated expenses

Amounts requested from other sources

$______Research Development Grant

$______Fund for the Improvement of Undergraduate Education

$______Director of Continuing Education

$______Department of ______

$______College of ______

$______Source External to Penn State

$______Global Fund

$______Other Sources sought or received ______

$______Total requested from other sources

Amount requested in this application

$______Total estimated expenses (from above)

-$______Less total requested from other sources (from above)

$______Total requested in this application

If your proposal is eligible for 100% funding:

$______1/3 of total requested (PDF amount for full-time faculty)

$______2/3 of total requested (DAA amount for full-time faculty)

$______1/2 of total requested (PDF & DAA amounts for part-time faculty)

If your proposal is eligible for 50% funding:

$______50% of total expenses (PDF amount for all faculty)