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Applicant Information
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Must be 5 digits. Currently Entered: 0 digits.
Employee/Student 5-digit of NUID number.
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Please include "@peru.edu"
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Academic Information
If your request is for a course, please continue with this portion. If your request is for a conference or workshop, please proceed to the next section.
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Expected Cost of Course (per credit hour)
$
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Requested Fund Amount
$
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Requests may be made up to $500.
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Conference/Workshop Information
If your request is for a course, please disregard this section.
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You may leave the 'Street Address' field blank, if you prefer.
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Registration Fee
$
.
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Requested Fund Amount
$
.
Requests may be made up to $500.
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Remove default code from box and enter provided travel number/code.
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How will this course or conference apply to your current position here at Peru State College as well as enhance you professionally?
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Uploads may include up to five files.
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I understand this is a legal representation of my signature.
Clear
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