Early Career Participants Support
Application for Geocomputation 2015
Contact Information
Name
Position
Institution
Street Address
City ST ZIP Code
Country
E-Mail Address
Phone
Eligibility
Are you a graduate student?
___ Master’s
Did you receive a PhD within the last 5 years (i.e., after May 22 th, 2010)?
If Yes, granting institution:
______________________________________
___ No
___ Yes
___ No
Date: _______________________
Will you present a paper or a poster at Geocomputation 2015?
For what did you register?
___ PhD
___ Yes
___ Conference
___ No
___ Workshop
Requirements
________
(initial)
I agree to respond in a timely fashion to a survey that is designed to evaluate the impact of
this conference attendance grant, if this grant is awarded. This survey is scheduled to be
sent out in November, 2015.
________
(initial)
Any funds awarded require me to submit receipts in a timely fashion after the conference
ends to get reimbursed for eligible expenses. Upon availability of funds, this award supports
up to $500 in eligible expenses for an awardee from the United States or Canada, and up to
$ 750 for an awardee from other counties.
________
(initial)
If I am an awardee from the local (i.e., Dallas-Ft. Worth) area, I am eligible to get reimbursed
only for the conference and workshop registration fees.
________
(initial)
If I am an awardee who registers for a workshop but not for the conference, I will be eligible
to be reimbursed only for the workshop registration fee (i.e., no travel support).
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that
if I am awarded a conference attendance grant, any false statements, omissions, or other
misrepresentations made by me on this application form may result in my immediate forfeiture of my
award. In addition, I will forfeit my award if I do not deliver my presentation.
Name (printed)
Signature
Date