[NAME] [DATE] Thank you for your interest in the UMN GSSPC’s Developing Young Innovators Travel Award. This is a competitive, merit-based $500 travel award for bachelor- and graduate-level scientists studying in Minnesota and surrounding states, who plan to present at the upcoming the 2015 Fall ACS conference. Please check the eligibility and submission criteria below before completing the application. Eligibility: The UMN-GSSPC’s Developing Young Innovators Travel Award is open to students who meet the following criteria: Must be a full-time student at an ACS-accredited institution in IA, MN, ND, SD, or WI Must be attending and presenting (either a poster or a talk) at the 2015 Fall ACS conference Submission: Please complete the following application, be sure to fill in the “author header” as pages may be divided during review Submit as a PDF attachment to gsspc@umn.edu Send the reference letter document to your research adviser. All application materials, including the reference letter, must be submitted by June 5th Page 1 of 5 [NAME] [DATE] Please fill out your basic information: Name: Field of Study: Are you a full-time student? Degree in Progress (bachelor’s, master’s, Ph.D.): Expected year of graduation: Institution, City, State: Will you be attending the 2015 Fall ACS conference? Have you submitted an abstract to the 2015 Fall ACS conference? Is this the first national conference you will attend? Page 2 of 5 [NAME] [DATE] Please tell us about your upcoming ACS presentation ACS Division: Title: Abstract: Page 3 of 5 [NAME] [DATE] Please fill in the following CV: GPA: List of Academic Scholarships and Awards: Insert text here List of Research Experiences (Position Title, Institution, Year Began- Year End, Supervisor): Insert text here List of Publications and Research Presentations (if none, fill as “N/A”): Publications: Insert text here Presentations: Insert text here List of Academically Relevant Extracirrcular Activites (STEM-relevant clubs, volunteering, teaching experience, etc.): Insert text here Page 4 of 5 [NAME] [DATE] Please respond to the following prompts, keeping your responses to 200 words or less. Please keep in mind that these will be evaluated by graduate students from different divisions, with regards to the application’s overall intellectual merit and the applicant’s` commitment to science. Describe your future research interests to a non-specialist. Why are you interested in attending our symposium? Page 5 of 5