The Royal Society of Chemistry Analytical Division

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The Royal Society of Chemistry Analytical Division
ATOMIC SPECTROSCOPY GROUP
BURSARY APPLICATION FORM
Name:
Date of Birth:
Business Address (for correspondence):
Telephone:
Fax:
E-mail:
Present Qualifications:
Membership of the Royal Society of Chemistry
Category of Membership:
Membership of RSC Analytical Division
Other affiliation (please specify):
*
Please delete as applicable
Brief Title of research Programme / Area of Interest:
Supervisor / Manager:
Department:
Institution / Company:
Yes / No*
FRSC / MRSC / AMRSC
Yes / No*
Conference Details
Name of Conference:
Venue:
Date(s):
Type of contribution:
Paper
Accepted / Submitted*
Poster
Accepted / Submitted*
*
Please delete as appropriate
Estimated items of expenditure (in £ sterling) assuming cheapest possible options:
Air fare
£
Train / bus fare
£
Registration fees
£
Accommodation and meals
£
TOTAL
£
Financial support requested (in £ sterling):
Assured:
Applied for:
University
£
£
Conference Organisers
£
£
Other sources (please specify)
£
£
OVERALL TOTAL
£
£
NOTE: PLEASE ATTACH A COPY OF THE ABSTRACT SUBMITTED
To whom should the cheque be issued?
University / department / individual
Please give details:
Signed:
Date:
Signature of supervisor (if a student bursary is to be awarded):
PLEASE NOTE THAT AS A CONDITION OF SUPPORT, A 250 – 500 WORD
REPORT MUST BE SUBMITTED TO THE COMMITTEE AFTER
ATTENDANCE AT THE CONFERENCE. THEN, WITH THE APPLICANT’S
PERMISSION, THIS WILL BE PUBLISHED ON THE ASG WEBSITE.
Please complete and return this form, with a copy of your submitted abstract to:
Dr. Andy Fisher,
Secretary of the Atomic Spectroscopy Group
School of Earth, Ocean and Environmental Sciences,
University of Plymouth,
Drake Circus,
Plymouth.
PL4 8AA
Tel: 01752 233003
Fax: 01752 232406
E-mail: [email protected]
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