SCHOOL OF HEALTH AND HUMAN SCIENCES UNCG Application for Graduate Student Travel Award Student name ________________________________________________________________ Department _____________________________ Advisor ____________________________ Conference Attended (or to be attended): ____________________________________________________________________________ Dates of Conference: _____________________ Location: ____________________________ Title of presentation: ___________________________________________________________ ____________________________________________________________________________ Authors: _____________________________________________________________________ Type of presentation (circle one): Oral presentation Poster Other (describe) Other financial support you received for presenting at this conference (indicate source and amount)_____________________________________________________________________ Student signature __________________________________ Date ______________________ Student email address _________________________________ Travel awards are for a maximum of $200, and funds are available only after the travel is complete. Travel must be completed between July 1, 2015 and June 30, 2016. Because funding is limited, eligibility is restricted to students who were authors (or co-authors) on papers or posters presented at a professional conference. Applications should be submitted to Heather Mitchell, University Program Associate, 235 Stone Building. (hsmitche@uncg.edu). Once approved, in order to receive funding, students must submit a travel reimbursement form (completed by the student’s department) to Heather Mitchell. _________________________________________________ Date _____________________ Associate Dean