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1.   NAME:_________________________ Team & Mail Drop Room #:_______________

Date:__________        Employee ID #:_____________ Phone #:_____________________

Name of Conference/Workshop/Activity:________________________________________

Sponsoring Organization:__________________ Destination:________________________

Conf./Workshop Dates:____________ Travel Dates: (depart) _______ (return) _________

          ____________________________________________________________

**Is a STATE VEHICLE requested? ___ Dates ______
Depart. time ___   Return time ____  Number of passengers______
List Passengers' names and University status (faculty/staff, student employee, student, other)
          ____________________________________________________________
 

2.   TRAINING: Please follow the special instructions and attach appropriate documentation. Approval and funding for training are a function of Cabinet.
 

REQUEST FORM

CRITERIA & PROCEDURES

 

3.   CONFERENCE/PROFESSIONAL DEVELOPMENT ACTIVITY related factors:
      For PROFESSIONAL FUND ONLY!
List all conference/activity responsibilities and explain your role in each.
Attach a separate sheet if necessary.
Please attach copy of prelim. program and registration form showing conference/activity dates.

Basic:
___ Attendance (35 pts)
___ Association membership (5 pts)
 
 

Service:
___ Elected officer/Appointed board member   (20 pts for 1- 2 positions; 25 pts total for 3+)
       (list position(s) held)__________________________________________________

___ Committee member   (10 pts for 1-2; 15 pts total for 3+)
       (list committees)_____________________________________________________
       ___________________________________________________________________

___ Committee chair    (10 pts for Chair of 1 committee; 15 pts total for 2+)
       (list committee chair positions)  __________________________________________
       _____________________________________________________________________

___ Panel/session  moderator or invited presenter on a panel   (10 pts for 1 - 2; 15 pts total for 3+)
       (list panel/session title and participation level)
        ____________________________________________________________________
 

Scholarship:
___ Delivering a paper   (20 pts for 1; 25 pts total for 2 or more)
      (list title of paper/presentation) ___________________________________________

      ______________________________________________________________________

___ Presenting a poster session  (10 pts for 1 - 2; 15 pts total for 3+)
       (list title of session)  ____________________________________________________

      ______________________________________________________________________
 
 

Strategic Values: (see instructions on necessary documentation)

check one only, and only if applicable (focus is on Scholarly Communication, Information Literacy, Diversity, Higher Education Partnerships, etc.; or on strategic Library work; does NOT include library and museum association conferences such as ALA, SLA, ARLIS, ACRL, ...)

     ___ Directly related to personal or team performance goal
            – attach a  goal statement and a brief  statement of justification (10 pts)
                 ______ team leader initials  - certifying that this travel furthers Library strategic goals or Team goals or personal goals  AND is not a library/museum association conference (such as ALA, SLA, ARLIS, etc.)

    ___ Directly related to Library Strategic Goals – with direct benefit to Library and customers
            - attach the goal statement and a brief  statement of justification  (10 pts)
                 ______ team leader initials  - certifying that this travel furthers Library strategic goals or Team goals or personal goals  AND is not a library/museum association conference (such as ALA, SLA, ARLIS, etc.)
 
 

Special Considerations:
___ Novice Academic Prof. w/less than 5 yrs in profession – first 3 trips only* (20 pts)
        * These 20 points can ONLY be used for the first three out-of-state trips taken!

___ Other (5-10 pts)  (must attach/supply supplementary material to support request)
 
 
 

 4. FUNDING REQUESTED:

5. TYPE OF FUNDING (select one)
__  Professional Travel *    (send form to Travel Committee, Main A347)

__  Classified Staff Travel *   (send form to Travel Committee, Main A347)

__  Training (send form to Training, Main A304, after you have been notified that your request has been approved)

__ Dean-Directed Travel    (send form to Dean's Office, Main A347)

__ Project Team Travel (send form to the ABaC$ assigned to your project team, Main A304)

* Professional/Classified Staff Travel is to be reported on an Allstaff Exception Slip.
 

6.   I have discussed my anticipated professional and research activities, including the level of participation, professional commitments and goals, with my team and/or team leader.
 

____________________________________	___________________________________
Employee Signature	Team Leader Signature

___________________________________________________________________________

ADMINISTRATIVE USE ONLY:
7. FUNDING APPROVED:
                                          Reimbursement pts       Funding Allocated      Initials/date/FUND CODE
Travel Committee                ________________        UP TO _______         _____________________
Training                              ________________         UP TO _______         _____________________
Dean-Directed                    ________________         UP TO _______         _____________________

See the following web site for Travel Safety Information -- http://www.kevincoffee.com/safety_tips_index.htm

revised 01-05-05
Questions? Contact Bonnie Travers, traversb@u.library.arizona.edu