Academic Undergraduate Programs
1322 Symons Hall
College Park, Maryland 20742
301.405. 6892 TEL 301. 405 .1655 FAX
COLLEGE OF CHEMICAL AND LIFE SCIENCES
Fourth Annual Bioscience Day Education Symposium
Celebrating Darwin’s Life and Legacy
November 12, 2008
Reimbursement Request
The University of Maryland will provide substitute teacher support for your attendance at
the UMCP HHMI Bioscience Day Teaching Symposium.
1. Please complete this form.
2. Send our office an advance copy via EMAIL (mshofner@umd.edu) or
FAX to 301-405-1655; Attention: Dr. Marcia Shofner before NOV. 7th.
3. Bring a copy with you to the symposium on Wed. Nov. 12, 2008 & hand in at check-in.
Teacher’s name:
School name:
School district:
School district address:
Contact name and phone number for
reimbursement questions:
School district’s federal tax ID number:
Substitute Teacher’s name:
Basis for reimbursement amount:
(County or school rate)
Total amount to be reimbursed:
Signature of School Principal: Signature of Symposium Participant:
Verification of conference attendance -
signature of CLFS employee on 11-12-08