TETFund CONFERENCE ATTENDANCE NOMINATION FORM

(To be completed by Candidate and Beneficiary Ins tu on)

I. Name of Beneficiary Ins tu on: ……………...............…………...……………………………………………………

ii. Name of Candidate/Staff: ……………………………...............……...……………………………………………....….
iii. Gender: Male Female
CANDIDATE'S
iv. Date of Birth: …………………………………………………...............…...……....…………………………………………. PASSPORT
v. Present Posi on (For Principal Officers):………...............……...……………………………....…………………. PHOTOGRAPH
vi. Staff Category: Teaching Staff Non Teaching Staff
vii. Phone Number/ Signature:…………………………………...................…………………………………………..……

S/N CANDIDATE’S DATA/INSTITUTIONAL RECORD

1. Department
2. Qualifica on
Highest Qualifica on………………………………… Area of Specialisa on…………………………………………………...
3. Rank
4. Grade Level
st
5. Date of 1 Appointment
6. Dura on of En re Work
Experience
7. Number of Years Spent
in the Ins tu on
8. Conference to be Conference Details:
A ended
a) Conference Organiser(s):…………………………………………………………………………………………………..
b) Title & Venue:……………………………………………………………………………………………………………………..
c) Registra on Fee:…………………………………………………………………………………………………………………
d) Date:…………………………………………………………. Dura on:……………………………………………………….
9. Conference A endance Last Interna onal Conference A ended (Sponsored by TETFund):
History a) Title:…………………………………………………………………............................................................. .....
b) Date:…………………….. Venue:……………………………………………………………………………………………
c) Publica on from the conference presenta on (as cited) :……………………………………………………
……………………………………………………………………………………………………………………………………………
10. Candidate’s Salary
Account Details
a) Bank Name & Branch:………………………………………………………………………………………………………..
b) Account Name:…………………………………………………………………………………………………………………..
c) Account Number:……………………………………………………………………………………………………………….
d) Sort Code:………………………………………………………………………………………………………………………….

…………………………………………………………………….............. …………………………………………...........………………………………
Name & Signature of Vice Chancellor/Rector/Provost Name & Signature of Director Academic Planning/DVC
(Including Stamp) (Academics)(Including Stamp)
Note: Any form that is not properly filled will be automa cally disqualified