EmailMe Form - Student Conference Travel Award Application

Does/Did this study require Institutional Animal Care and Use Committee or Institutional Review Board Approval?

Yes

No

Has it been approved?

Yes

No

Lead Student Name *

First Last

Lead Student Email *

Today's Date *

MM / DD / YYYY

Sponsor Emails (Place comma between each address.)

Other Student Researcher Emails (Place comma between each address.)

Name of Conference *

Location (City, State)

Title of Presentation *

Conference Start Date *

MM / DD / YYYY

Conference End Date *

MM / DD / YYYY

List all Authors in Submission Order *

Travel Dates

MM / YY

Location (City, State)

Project Description: One paragraph project summary that can be understood by the general public.

Copy and paste the abstract of your presentation below.

In the description section, please explain how costs were calculated (i.e. 3 rooms at $150, # miles roundtrip, # people X days, etc.). Use the mileage reimbursement form from the Business Office to calculate the mileage costs.

	Cost	Description	Total Cost
Hotel/Room
Registration
Mileage
Airfare
Meals
Other Expenses

GRAND TOTAL (sum of total costs above)