Graduate School of Life Sciences Isabelle Bouhon Fund TRAVEL GRANT APPLICATION FORM Name: Department: Name of Supervisor: Address for correspondence: Email Address: Conference / Event: From: To: Location: Presenting: talk poster nothing this time other (please specify) Title: If you are submitting an abstract to a conference/event, please attach a copy to this application. Please list costs you wish to apply for (e.g. airfare, registration fees, accommodation); please include the total cost, although please note that awards for travel within EU will generally be limited to £300 and awards for international travel to £600 TOTAL Amount Have you applied for any other funding to cover these costs? No Yes If yes, please specify the following: Source of funding applied to __________________________________________ Amount applied for _________________________________________________ What expenses will be covered? _______________________________________ When was / will this be decided? _______________________________________ Statement by student in support of the application: Supervisor’s comments: Please tick box to confirm that this student is undertaking research in the field of Stem Cell or Regenerative Medicine Signed (Supervisor) Date Please return the form to: Larissa Jorna, Higher Degrees Office, School of Clinical Medicine, Cambridge Biomedical Campus, PO Box 111, Hills Road, Cambridge, CB2 2SP Email: lkj27@medschl.cam.ac.uk