UWF - Office of Undergraduate Research - Travel Award Funding Request

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All fields are required. Please be sure to only upload .doc, .docx, .pdf, or a .zip of multiple files.

For groups of two or more students traveling to the same conference, identify one student to serve as the contact and enter his/her information only. Add additional student names below and attach all acceptance letters if more than one project is being presented. IT is strongly encouraged you contact the Student Government Association and your college dean's office to request additional funding and indicate these additional sources of funding in your budget description.

General Information

Name:

UWF Student Number:

Email:

Telephone:

Street Address

City	State	Zip Code

Major:

Year:

Expected Graduation Date:

Grade Point Average:

Student Name:
UWF Student Number:

Project Information

Project Title:
Associated Department:
College:
Duration of Project:	-
Faculty Mentor:
Mentor Email:
Course Number & Name Related to Project:
Total Funding Requested:	$ .00

Proof of Poster/ Presentation Acceptance:

(.doc, .docx, .pdf, .zip)

Summary Statement

Provide a brief summary of your travel or presentation intentions. Include as appropriate brief descriptions of the venue and importance of the presentation (i.e. a "poster to be presented at the National Conference on Undergraduate Research" or "a paper to be read at the National Collegiate Honors Council meeting"). Clarify as best you can the importance of the venue in your discipline (i.e. the American Psychological Association meeting is the premier national academic conference in Psychology") and how this presentation will enhance your educational goals. If you are pasting from Word, please use the Word Pasting Tool on the toolbar.

Please provide a brief budget description:

Please itemize your expenses, including registration fees, air or fuel charges for travel, hotel expenses, etc. If you are receiving additional sources of travel funding please indicate below. If you are pasting from Word, please use the Word Pasting Tool on the toolbar.

By typing my name, I certify this presentation adheres to the requirements of the OUR by directly promoting undergraduate research at the University of West Florida and the work presented using this travel award was a collaboration between myself and a faculty mentor. I understand that if I fail to complete the program assessment survey, I will repay the sum total of the award.

Digital Signature:

Date: 05/20/2013

(If you can see this field don't fill it out.)