Application Form - travel.doc

NZSGTravel Funding Application Form

Australian Synchrotron

Applicant’s name:
Institution:
Department:
Phone:
Email:

Proposal Details

Beamline
Cycle and dates
Proposal number and title

Is this proposal:

Merit access? / Preferred access?
One-off / Preliminary? / Ongoing?

Please attach a copy of your proposal and any reviewers’ comments or score to this application.

Amount of funding sought for ALL researchers listed on page 2:

Airfares
Other transport
Total

Please provide a breakdown of the amounts requested above. (You may also attach a travel agent’s quote)

Amount of other travel funding secured, and source(s):

If you have received funding from NZSG before, please give details:

For statistical purposes, please list your source(s) of project funding:

Group Details

Please provide the following details for all researchers whomthis application is for:

(duplicate this page if necessary)

Name:
Institution:
Department:
Email:
Indicate with X if applicable:
Post-grad / Post-doc / Early career researcher
Please select one of the following:
New user / Experienced user / Expert user
Name:
Institution:
Department:
Email:
Indicate with X if applicable:
Post-grad / Post-doc / Early career researcher
Please select one of the following:
New user / Experienced user / Expert user
Name:
Institution:
Department:
Email:
Indicate with X if applicable:
Post-grad / Post-doc / Early career researcher
Please select one of the following:
New user / Experienced user / Expert user
Name:
Institution:
Department:
Email:
Indicate with X if applicable:
Post-grad / Post-doc / Early career researcher
Please select one of the following:
New user / Experienced user / Expert user

Please list all other collaborators involved in the project and indicate if they will also be travelling under other funding to conduct the experiment:

Please provide any other information you think may be relevant to your application:

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