The ICGD Faculty Award
The ICGD Faculty Award
Name
Name
First
Last
Title and Rank
Department
College
Phone
Phone
-
###
-
###
####
Email
I. Conference Information
Name of Conference
Location
From Date
From Date
/
MM
/
DD
YYYY
To Date
To Date
/
MM
/
DD
YYYY
Title of Presentation
II. Expenses: A cost estimate of the proposed activity.
Transportation:
$
Dollars
.
Cents
Lodging (room rate x days):
$
Dollars
.
Cents
Conference Registration
$
Dollars
.
Cents
Miscellaneous (must be documented):
$
Dollars
.
Cents
Total estimated or actual expenses:
$
Dollars
.
Cents
Contributions from a grant or source other than your personal funds:
$
Dollars
.
Cents
Amount requested:
$
Dollars
.
Cents
III. Activity
Title of Research Project/Creative Activity
200-Word Abstract of Your Work
Concisely describe the significance of this work in relation to the ICGD's mission.
List of Relevant Publications or Creative Works