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President's Fund for Faculty and Staff Development and Support

*For Multi-line Textboxes, Please use your Preferred Word Processor to Assist in Answering These Questions, and Simply "Copy and Paste"

**The President’s Fund will not consider proposals for travel outside the continental United States

Group or Individual*
Group or Individual Address*
Group or Individual Phone*
Event Title*
Performer(s) Name(s)*
Event Date(s)*
Event Time(s)*
Event Place*
Space is Reserved*Yes
No
Facility Capacity (number)*
Projected Audience (number)*
Event Format*Lecture
Performance
Workshop
Conference
Other
Event Format (other)
Authorized Signer/Travel Contact (Full Name as AUTHORIZED SIGNATURE)*
Employee #*
Address*
City*
ZIP/Postal Code*
Home Phone*
Business Phone*
Email*
Event - Designated Budget (Total Cost in Dollars)*
Event Summary*
Event Contact Person*
Event Contact Person's Work Number*
Event Contact Person E-Mail Address*
Give a brief synopsis of the content of the event (i.e., topics to be discussed, etc.).*
Explain how sponsoring this event will benefit your campus (the wider university) community? What will your group do with the experience/information gained by holding such an event?*
What type of forum is your group planning to utilize to involve the campus about the information from this event?*
If your group has sponsored this event in the past, please summarize experiences and funding history.*
Travel Information | Name of Conference or Travel Business:*
Travel Destination*
**Dates of Travel (departing and returning)*
**Number of Travelers*
**Traveler 1*
**Traveler 1 Employee ID*
**Traveler 2*
**Traveler 2 Employee ID*
**Traveler 3*
**Traveler 3 Employee ID*
**Traveler 4*
**Traveler 4 Employee ID*
**Authorized Signer/Travel Contact (Must be a Traveler) (Full Name as AUTHORIZED SIGNATURE)*
Travel Contact Address*
Travel Contact Home Phone #*
Travel Contact Work Phone #*
Travel Contact E-Mail Address*
Travel - Designated Budget (Total Cost in Dollars)*
Breakdown In Regards to Budget*
Give a brief synopsis of the content of the conference/competition (i.e., topics to be discussed, etc.) If you are attending a conference, please (if possible) scan and email Vicky.Saulsberry@UCDenver.edu the conference brochure.*
Is your group a member of or have a relationship with the conference’s sponsoring organization? If not, how did your group learn about the conference/competition?*
Explain how attending this conference/competition will benefit your campus (the wider university) community? What will your group do with the experience/information gained by attending?*
What type of forum is your group planning to utilize to inform your campus about the information from this conference/competition?*
If your group has attended this conference/competition in the past, please summarize experiences and funding history.*

Office of Inclusion and Outreach

University of Colorado Anschutz Medical Campus

13120 East 19th Avenue | Educaton 2 North 3118

Aurora, CO 80045

o 303.724.8003 | f 303.724.8006 | e OIO@UCDenver.edu

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