HHS Conference Attendance Request and Approval
Other versions of this form: DOC - 2 pages; PDF - 2 pages
Operating/Staff Division Information
| Questions | Answers |
|---|---|
| Operating or Staff Division: | |
| Office: |
Conference Description
| Questions | Answers |
|---|---|
Title/Topic
| |
Name of Agency/Organization Hosting the Conference
| |
| Purpose for Attending the Conference | |
| Dates To Be Held | |
| City | |
| State or Country |
Cost Information
| Questions | Answers |
|---|---|
| Total Estimated Cost | $ |
| # of Attendees Requested | |
| Cost Per Attendee | |
| Reason why so many attendees must attend | |
| If an annual conference, number of attendees from the past conference and reason for any change |
Details on Cost
| Questions | Answers |
|---|---|
| Registration Fees | $ |
| Travel Costs: | $ |
| Other | $ |
| Explanation of Other Costs |
Requestor Information
| Questions | Answers |
|---|---|
| Name | |
| Title | |
| Office | |
| Signature
|
OPDIV/STAFFDIV Approval
| Questions | Answers |
|---|---|
| OPDIV/STAFFDIV Head Signature | |
| Date |
Secretary Approval:
Concur: ___________ Non-Concur ___________
Signature: _____________________________________________________
Date: ______________________________________