AAAI STUDENT SCHOLARSHIP FUND APPLICATION FORM

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AAAI STUDENT SCHOLARSHIP FUND
APPLICATION FORM
AAAI Membership I.D. #:________________________
Name: ___________________________________________________________________________________
Institution & Department:
___________________________________________________________________
Address: __________________________________________________________________________________
_______________________________________________________________________________________
Email address:
Telephone (daytime):
Active participation in AAAI-98(yes/no)
Circle One:
___
technical paper presentation
active workshop presentation
other (specify)
___
___
If no, please include letter of recommendation from your faculty advisor.
Faculty Advisor: _______________ Email address: _____________________________________________
Address: __________________________________________________________________________________
_______________________________________________________________________________________
Other sources of funding: _____________________________________________________________________
Budget: Travel (eg. air, auto)
_____________________________
Housing
_____________________________
TOTAL
_____________________________
Please note that air travel should be based on supersaver fares and housing should be based on the available
student housing rates. Housing will be available at University of Wisconsin-Madison for approximately $40 per
night.
I agree to submit an expense report to AAAI after the conference for scholarship funds awarded to me. I
understand failure to do so will jeopardize future participation in the scholarship program.
Signature: ________________________________________________________________________________
Date _____________________________________________________________________________________
DEADLINE DATE IS APRIL 15, 1998
_______________________________________________________________________________________
AAAI USE ONLY
Accepted:________________
Amount: ________________
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