Student Travel Grant Application (2006-2007)

Student Requesting Travel Money                                                                   Date             

Class year of student                                     

Faculty Mentor                                              

Conference you are attending:                                                           

Location of Conference:                                                                    

Type of presentation you are giving:                                                 

If this is a co-authored presentation, are you the presenter?: _____________

Title of Presentation:                                                                                                              

Requested Itemized Expenses (Further justification may be expected):

Expense                                                           Cost

1)

2)

3)

4)

5)        

Total Requested                                                                                                                                           

Total Approved by the Dept.                                                                                     

If you will be sharing these expenses with someone else please explain:

Signature of Traveler                                                              Date                          

Signature of Mentor                                                                  Date                         

You must email to the Department Chair a copy of the Title, Authors, and Abstract that was submitted.