TRAVEL GRANT APPLICATION FORM – Student Applicants Graduate School, Faculty of Medical Sciences Part A – To be completed by the Applicant Name Address Degree Year of Study Institute Supervisor Title of Research Project Reason for Application (if attending a meeting state full title; if visiting a laboratory provide supporting documentation) Explain the importance of the visit for development of your research project (maximum 200 words) Nature of any presentation (provide supporting documentation, and state the title of a paper or poster presentation) Approved GSC 6.3.12 Destination Details of proposed travel (give details of dates and routes) Expenditure (list all estimated fares, accommodation and subsistence costs) Is funding from any other source possible (eg: professional society, conference organisers, department or research grant)? If an application has been made elsewhere, when will you know the outcome? Are your PhD studies funded through a studentship? YES/NO If YES: i) Please give details of your funding scheme (e.g. BBSRC DTP; MRC Industrial CASE; CRUK). ii) Does the studentship include any provision for travel? If any application has been made elsewhere, when will you know the outcome? Statement by Applicant: I confirm that I have not previously received an award from this fund during my period of higher degree registration. Any award made will be used only for the travel indicated. Adequate evidence of expenditure will be submitted in due course. Before I travel I will contact the Insurance Office (insurance@ncl.ac.uk) to arrange adequate insurance. Signature Approved GSC 6.3.12 Date Part B – To be completed by the Supervisor Comment on the contribution of the proposed travel to the student’s research training programme. Name any other student(s) from your group who is/are applying for funds to travel to the same venue. Justify why more than one student should attend and rank the applicants in order of priority. Supervisor’s signature Date Head of Institute’s signature Date Completed applications and any enquiries should be addressed to the Graduate School Office, Medical School, extension 7002. Applications should be made as far in advance as possible. Applications will be considered at these times only: 1st February, 1st May, 1st August and 1st November. Retrospective claims will not be considered. Approved GSC 6.3.12