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UIC home > LAS home > Faculty and Staff > Forms > Junior Faculty Research and Travel Request

LAS JUNIOR FACULTY RESEARCH SUPPORT TRAVEL FUND REQUEST

DATE:
NAME:	DEPT:
EMAIL:	M/C:

DATES OF EVENT/TRAVEL: to	LOCATION (City, Country):
NAME OF EVENT /SPONSORING ORGANIZATION/RESEARCH SITE:
NATURE OF PARTICIPATION IN EVENT / RESEARCH: Please fill in this information using return key; only visible text will print. ATTACH COPY OF INVITATION AND ADDITIONAL PAGES IF NEEDED.

ESTIMATED EXPENSES:
Airfare:
$ + Other Transport $ =	$
Registration:	$
Lodging (number of days x rate):	$
Other (Specify): Please use keyboard return key; only visible text will print. ATTACH ADDITIONAL PAGES IF NEEDED.	$
TOTAL ESTIMATED EXPENSES:	$
STATEMENT OF CHAIR / HEAD (with signature):
Please use keyboard return key; only visible text will print. ATTACH ADDITIONAL PAGES IF NEEDED.
Applicant Signature (Please sign/date on printout):

College of Liberal Arts and Sciences
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Administration Tel: (312) 413-2500 | Fax: (312) 413-2511
Student Academic Affairs & Advising Tel: (312) 996-3366 | Fax: (312) 413-8577

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Last Modified: Friday, 02-Sep-2011 15:19:17 CDT