Conference Travel Grants for College of Sciences Undergraduates: Application

GTID *

First Name *

Last Name *

GT email *

Major *

Last Name of Faculty Advisor *

Name of Conference *

Location (City, State, Country) *

Email address of faculty advisor *

First Day Attending Conference *

Month

Day

Year

Last Day Attending Conference *

Month

Day

Year

Title of Accepted Poster or Oral Talk *

Estimated Cost

Airfare

Vehicle

Other transportation

Meals

Lodging

Other

Registration fee

Total cost *

Other Funding Sources

Date of SGA Application *

Month

Day

Year

Amount of funding provided by the SGA fund *

Date of PURA Application *

Month

Day

Year

Amount of funding provided by the PURA travel fund *

Amount of funding provided by my faculty research advisor or School *

I have shared this information with my faculty research advisor and they support this application for CoS Travel Funding *

Yes

I understand that it is my responsiblity to submit a Georgia Tech Travel Authorization Form (prior to travel) and Travel Expense Form (upon competion of travel) *

Yes