FSA-College of Arts & Sciences Pre-Approval Form

FACULTY SCHOLARSHIP ACCOUNT (FSA) Pre-Approval
Request Form 2025-2026
Due Dates: 9/10/25, 11/12/2025, 2/11/2026, 4/8/2026

Requestor's Name Requestor's Name First Last
Requestor's Title

Full Professor, Associate Professor, Assistant Professor or Instructor.
Department
Requestor Email
Department Chair Email
Administrative Assistant Email
Date of last FSA Funding:
Amount of last FSA:
Pre-Approval Application

*please check the acknowledgment box below*
Check the box to indicate your agreement with the statement

Check the box to indicate your agreement with the statement I acknowledge that all paperwork must be submitted within 30 days after my travel. I will submit all documentation to my department administrative assistant ASAP to allow them time to review. (IF APPROVED)
ITEMIZED ESTIMATE OF EXPENSES
*** User may Save & Return to this form! HERE'S HOW: ***

1. Check the box below to 'Save my progress and resume later'.

2. Enter your email address when prompted, then click on the "Save form and resume later" button. You will receive an email with a resume link.
Name of Conference/Event/Purchase:
Location (if applicable):
Start Date: Start Date: / MM / DD YYYY
End Date: End Date: / MM / DD YYYY
Foreign Travel?

Foreign Travel? Yes No
Contact Laura Merkl or Jessica Pruss with any questions regarding foreign travel.

For foreign travel, please copy the following link and complete this form as well:
Export Controls
https://forms.brockport.edu/view.php?id=8746338
TRANSPORTATION

*Travel must be in the best interest of the University and the most economical method of travel must be used. It is the traveler's responsibility to secure the most economical method of travel in the best interest of the University.*
Rental Car ($USD)
Personal Mileage ($USD)
Air Fare ($USD)
LODGING
Lodging ($USD)

If over per diem rates, justification for lodging must be provided.
MEALS AND OTHER EXPENSES
Meals ($USD)

Please use the per diem rates and follow the guidelines for meal reimbursement.
Other Expenses (example: Uber, parking, etc.):

Please describe, as necessary.
Registration ($USD)

*If registration is not in USD Please convert*
I am requesting my registration to be paid using a p-card. I will contact Jessica Pruss (jlpruss@brockport.edu) within one week of receiving pre-approval to arrange for registration.

If not USD $ Please convert

I am requesting my registration to be paid using a p-card. I will contact Jessica Pruss (jlpruss@brockport.edu) within one week of receiving pre-approval to arrange for registration. If not USD $ Please convert Yes No
TOTAL
Total Amount of Funding Requested:
Please describe the purpose of your travel or purchase expenses: Explain in some detail how they advance your scholarship.
Attach agenda/proof of acceptance if request involves conference travel. For reimbursement requests, once you receive this approved FSA form, please submit the appropriate NYS forms and supporting documentation (e.g., original receipts, invoices, etc.) to your department administrative assistant for review. After the department admin reviews your documents, they will be forwarded to the Deans Office for review and further processing.
Upload Supporting Documentation (up to 6 documents)
maximum 5 files whose total size may not be more than 10MB
filenames should not contain more than one period (.)
Upload Supporting Web Page (Link) (e.g., conference page, equipment purchase page, etc.)
Requestor: (Type Name)
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

FSA-College of Arts & Sciences Pre-Approval Form

Pre-Approval Application

ITEMIZED ESTIMATE OF EXPENSES

*** User may Save & Return to this form! HERE'S HOW: ***

Contact Laura Merkl or Jessica Pruss with any questions regarding foreign travel.

TRANSPORTATION

LODGING

MEALS AND OTHER EXPENSES

TOTAL

* User may Save & Return to this form! HERE'S HOW: *