ULM School of Pharmacy Student Affairs and Awards Committee

ULM School of Pharmacy
Student Affairs and Awards Committee
Student Travel Budget and Planning Form
Please fill out the form below as completely as possible and submit to Ms. Massey in OSPA no later than September 11, 2015. Any
forms received after this date will not be considered. Fill out one form for each anticipated meeting for the 2015-2016 academic
year. This information is to be used for planning purposes only, and is not a guarantee that your organization will receive the funds
denoted below. **All required travel paperwork must still be completed prior to each trip.
 Person filling out form & title ___________________________________________________________________________
 Organization name___________________________________________________________________________________
 Meeting name/title___________________________________________________________________________________
 Meeting date___________________________
Estimated no. attending________________________
 Location of meeting (city/state/country)__________________________________________________________________
Estimated total costs
Transportation (gas, rentals, airfare,
taxis, shuttles, parking, etc)
Per person
Meeting registration/fee
Other (list)
How much money do you anticipate your organization will be contributing to this travel, through fundraising or other
means? $________ total
How much money do you anticipate requesting from the School of Pharmacy to help fund this travel? $________ total
Is it required (by your chapter or the parent organization) that your organization send representatives to this meeting?
o If yes, how many? _____
Are those included in the number listed above? Y / N
Please feel free to (briefly) include any further information you feel is important for the Committee to know for the
budgeting process below:
**In addition, special consideration will still be given to students who are presenting research, participating in other competitions
not noted above, running for office, or taking part in other activities that bring prestige to our School (per the travel policy).