Applicant Information

* Name:

* E-mail address:

Institution:

Advisor's Name:

Degree Sought:

Masters

PHD

Graduation Date:

Research Type:

Preliminary

Final

Content of Research Conducted:

Thesis/Dissertation

Other

Presentation Type:

Oral Presentation

Poster Presentation

Travel & Funding Information

Travel Needs:

Travel Start Date:

Travel End Date:

Are you applying for other travel grants for this trip? (mark all that apply)

This Conference Funding Request:

Specify Amount:

Home Institution request (Name of Institution):

Specify Amount:

Other (Name Source):

Specify Amount:

Total Estimated Budget:

Airfare:

Mileage*($0.445/mi):

Meals** (max = $36/day):

Registration:

Car Rental:

Lodging:

*only if using own vehicle; **excluding meals provided with registration fee

Include:

* Research Abstract (as it was submitted to the conference)

* Letter of Intent (from student application):

What is the importance of your work and the relevance to the conference? (fewer than 250 words)

* Letter of Support from Advisor (Advisor's name)

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