Name _____________________________________
Undergraduate / Graduate (circle one)
Name of Meeting ___________________________
Date of Departure ___________________________
Date ________________________________
Advisor _____________________________
Meeting Dates ________________________
Date of Arrival _______________________
Location of Meeting _________________________________________________
Title of presentation __________________________________________________________________________________
___________________________________________________________________________________________________
Authors _______________________________
Presenter: ____________________________
I have applied for Graduate School funding on ___________________ (date).
I have applied for College of Science funding on ____________________ (date).
I have applied for other funding (e.g. grant from professional society) on __________________ (date)
Explain _______________________________________
I will receive $_______________ support from grant _______________________________
(please have PI initial here ______________ to confirm support)
____________________________________
A. Velasco, Chair
Estimated costs (please see notes below):
Meeting registration ___________________________
Transportation ___________________________
Lodging _________________________________