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.