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I. APPLICANTS DETAILS
Name :(( Prof/Dr/Ms)……………………..Staff No.:………….................................
Designation:........................................... Department:…………………………..
Nature of Employment
(i) Permanent (ii) Contract (iii) Temporary
Date of Appointment..................... to.............................. [in cases ii) and iii) above
2. DETAILS OF CONFERENCE/SEMINAR/SYMPOSIUM/WORKSHOP
Title/Organising Body:
……………………………………………………………………………………………………….......................
Venue…………………………………………………………………………………………………………
………………………………………………………………………………………………………………
Date:
From……………………………………………………………………………………
To……………………………………………………………………………………………………………
3. DETAILS OF ESTIMATED EXPENDITURE Source of finance: Tick. appropriate box
DUT
Other
3.1 Travel expenses
R............................
3.2 Registration fee
R......................
R.......................
3.3 Accommodation and
Subsistence
TOTAL
R..........................
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3.4 If you ticked OTHER in 3. 1 indicate source/s of funding applied for/received?
3.4.1
Name of Agency/Source……………………………………………………………………………………………
3.4.2
Amount applied for/received……………………………………………………………………………………….
3.5 If you ticked DUT in 3. 1 indicate DUTsource/s of funding?
………………………………………………………………………….....................................................................
4. PARTICIPATION DETAILS
4.1 Have you been invited to chair a session/participate on a panel/present a paper or poster?
Yes No
4.2 Is this conference/seminar/symposium/workshop directly related to your field of discipline?
Yes No
4.3 Motivation for this request (supporting documents, such as the nature of the
conference/symposium/seminar/workshop)
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
5. APPLICANT’S UNDERTAKING
A written report on the conference/seminar/symposium/workshop etc. will be submitted to the
relevant head within thirty (30) days of the event.
Signature of Applicant: ……………………………………………..Date: ………………………………
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6. RECOMMENDATION BY HEAD OF DEPARTMENT/LINE MANAGER
6.1 Submission of report from previous conference/seminar/symposium/workshop
Yes No
6.2 Confirm that the seminar/symposium/workshop is of:
an academic nature a professional nature
6.3 This application is Recommended Not Recommended
Signature:…………………………………………………………………………… Date:…………………………………
7. RECOMMENDATION BY EXECUTIVE DEAN/EXECUTIVE DIRECTOR
This application is Recommended Not Recommended
Signature:…………………………………………………………………………
Date:……………………………………
8. APPROVAL BY RELEVANT DEPUTY VICE-CHANCELLOR(For international Travel only)
This application is Approved Not approved
Signature:………………………………………………………………………
Date:……………………………………..
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9. SUPPORTING DOCUMENTS
CHECKLIST
Yes
No
1. Previous conference/seminar/symposium report
2. Information on conference/seminar/symposium (e.g. invitation, programme etc.)
3. Reference documents for figures (e.g. flight ticket quotation, conference
registration invoice etc.)
4. Acceptance of paper if presenting
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Document Outline