CONFERENCE TRAVEL AWARD APPLICATION
ENVIRONMENTAL SCIENCE AND POLICY GRADUATE STUDENT ASSOCIATION
I. Applicant Information:
Name:______G#:______
Phone:______Email:
Address: ______
Dept.: ESP MMB Other ______
Degree sought: M.S. Ph.D. Non-degree seeking
Circle the application deadline you are applying for: April 1October 1
______
Are you a current ESP student?YESNO
Are you a current ESP-GSA member?YESNO
(paid dues this semester AND attended at least one event)
**If you do not meet the above 2 requirements, please consider re-applying in a future semester after having met the requirements**
______
Have you previously been awarded YESNO
an ESP-GSA conference travel grant? When?______
II. Conference Information:
Name of Conference:______
Location:______
Dates: ______Type: International National State/Local
III. Level of Participation:
Please indicate your level of participation at the event:
Paper Presentation Poster Presentation Workshop Facilitator
Participant/Other
Title of Paper or Poster Presentation:______
Is your participation confirmed? (Has your abstract been accepted, etc.)YESNO
IV. Estimated Travel Expenses:
1. Conference registration cost: $ ______
2. Travel costs: Airfare $______
Car rental $ ______
Mileage (x $0.15) $______
3. Total estimated travel and conference cost (add #1 and #2): $ ______
** Please note: the GSA travel fund will not cover food or lodging expenses. The maximum award amount from the GSA is $250.
V. Other Sources of Support:
Please indicate ALL expected travel support from other sources, if funds have been secured, and what the funds may be used for:
I requested financial aid for this conference from:
GMU Graduate Student Travel FundFunds received $______
Purpose:______
Host Organization Funds received $______
Purpose:______
Other:______Funds received $______
Purpose:______
VI. Supporting documentation. The following must be submitted along with the application:
- Abstract of poster or paper to be presented not to exceed 500 words.
- Screenshots of estimated expenses from Section IV, i.e., airfare, conference registration, hotel, etc. Do NOT attach invoices or receipts to your application.
- Statement of purpose: 500 word statement about why this travel is important to the student’s academic progress and about the significance of the conference
- Confirmation of conference registration (receipt of payment etc)
- Confirmation of presentation acceptance (letter of abstract acceptance etc)
VII. Please read. By signing this form you agree to comply with the following:
- I understand that to be eligible for the ESP-GSA Travel Award, I must be an ACTIVE member of the ESP-GSA. I have attended at least 1 meeting / event in the semester for which I am requesting aid, have paid my membership dues, and am in good standing with the organization. Exemptions to this regulation may be made at the discretion of the ESP-GSA Officers.
- I understand that I am NOT guaranteed funds, as funds are extremely limited. I understand that preference will be given based on the level of participation at the event and the effort made to seek other sources of funding. My application will be reviewed by a panel consisting of: 3 GSA members, 1 GSA board member and the GSA faculty advisor. I understand that any funding awarded may range from the full amount possible to partial funding.
- I understand that by accepting these funds I am representing the ESP-GSA and Mason at this event, and will conduct myself in a manner that adheres to the mission of the ESP-GSA. If attending a conference after funds have been awarded, I will acknowledge the ESP-GSA for the assistance received by including the ESP-GSA logo in the Acknowledgements Section.
- I will provide the ESP-GSA with copies of receipts after the attending the event (registration receipt, gas receipts, etc.). After conference attendance, I will write a 500-word summary of my experience at the conference to be published, along with pictures, in the ESP newsletter. I understand that failure to complete either of these requirements will put me in poor standing with the ESP-GSA and jeopardize my funding.
- I understand that I am only eligible for ONE travel grant per year.
- I certify that the information provided is accurate to the best of my knowledge, and that I have attached all the required documentation. I understand that failing to provide the required documentation will render my application void.
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Signature of Applicant Date
______
Signature of AdvisorDate
Application updated 3/2017