Valhen Form
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Transcript of Valhen Form
8/7/2019 Valhen Form
http://slidepdf.com/reader/full/valhen-form 1/1
VALHEN – VIRGINIA LATINO HIGHER EDUCATION NETWORK – www.valhen.org
APPLICATION FOR LECTURE GRANT
Name of Institution: Name of Host: Address: Telephone/Fax: Email:
Proposed Speaker: Speaker’s Affiliation:
Speaker’s Title/Position:
Proposed Title of Talk:
Anticipated Date of Talk: Expected Size of the Audience:
Brief Biography of the Speaker (250 words maximum). Please indicate the speaker’s
educational background, current professional roles, expertise in the topic they will present, and
affiliation with the Latino community.
Budget for Speaker. Please identify the expected costs of the event including travel, food,
lodging, stipend, reception, etc. Identify any additional funding sources (e.g. university
departments or institutes) that will support the speaker’s visit or the event which the speaker is part of. Please calculate costs according to the federal per diem rate:
http://www.gsa.gov/portal/category/21287.
COSTS:
Travel:
Lodging:
Meals and Incidentals:
Reception:
Publicity:
OTHER FUNDING:
Source: Amount: Source: Amount: Source: Amount: Note: A one-page final report requiring receipts and publicity documentation will be due two
weeks after the event in order to receive reimbursement.