Region 35 Funding Request Form

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Please complete this form to receive funding to attend IEA's Early Career Spring Retreat April 5-6 at the Double Tree Hotel in Bloomington, IL. Funding for this event includes the cost of lodging and registration.

Please see the event website to register, find additional details, and for the agenda: https://web.cvent.com/event/90db06fa-8283-4f43-a7fd-a61c9720db09/summary

Please email Lori Mobley (lorimobleysea@gmail.com) with any questions.

First Name *

Last Name *

Cell Phone *

Personal Email (non-district) *

Base School *

Local Organization *

SEA

SEEO

Why do you want to attend this conference? *

How will you share information learned at this conference with your union and colleagues? *

Please select one response. *

This is my first time requesting Region 35 funding to attend an event.

I have received Region 35 funding in the past.

Other:

Previous conference(s) attended through Region 35 funding:

I understand that I may need to initially pay for the conference out of pocket and will complete and submit a Region 35 voucher to the Region 35 Treasurer for reimbursement. *

Yes

I understand that if I do receive an advance to attend the conference and am unable to attend, I will be personally liable for any prepaid costs (ex: lodging and registration). *

Yes

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