2019-20 King-Chavez-Parks Information/Reimbursement Form

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2019-20 King-Chavez-Parks Information/Reimbursement Form - Visiting Professor Program

NOTE: Submit this form within 30 days after your event has taken place. This form must be completed and returned at the same time bills are submitted for reimbursement to Heather Suokas in the Provost Office who will share the documents with the Assistant to the Provost of Academic Equity and Inclusion. No reimbursement will occur without this completed form. If the form is submitted late your award will be forfeited. (This information is required for the State of Michigan KCP final report.)

Email *

Department contact Information:

Host Name: *

Host Department: *

Department index number AND title that awarded funds are to be transferred into. *

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