TITLE III STRENGTHENING HBCUs GRANT PROGRAM

SUPPLEMENTAL REPORT ON TRAVEL/PROFESIONAL DEVELOPMENT ACTIVITY

NOTE: If your travel was funded by Title III, this form must be submitted with the Morehouse College “Travel Expense Statement” for travel reimbursement and reporting in order to help ensure compliance with grant terms.

NAME OF PARTICIPANT:
DEPARTMENT:
OFFICE PHONE NUMBER: / FAX NUMBER:
EMAIL ADDRESS:
TITLE OF CONFERENCE/WORKSHOP/SEMINAR:
DATE(S): / LOCATION:
SPONSORING ORGANIZATION:
What information did you receive from the conference, workshop, etc.? And, how will you use the information to enhance your performance, improve your program/activity, improve your area and the College?
Participant’s Signature / Date:
Supervisor’s/Activity Director’s Signature / Date:

Revised September 21, 2017