NSU University School Faculty, Staff and Employee Handbook

118 Appendix B Application to Attend Conference Form *Attach a copy of the official conference program with your application ** All authorization requests shall be reviewed by the division Director for initial approval and by the Associate Head for Academic Affairs for final approval NAME ___________________________________ Grade/Subject Taught ________________ Title of Conference ____________________________________________________________ Official dates/days of conferences shown on the registration form ________________________ Dates/days you wish to attend _____________________________________________________ Approximate Anticipated Costs (see “Reimbursement ” above and use the Expenses Worksheet to predict costs)) ________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Describe the benefit and potential outcome effects (gains) for you, for your colleagues and for the school. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ With whom will you share your conference experience? How? Why??______________________________________________________________________________ Approved by/ Director/date _____________________________________________________________ Deferred (explanation) ________________________________________________________________