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Summary: Page 1 of 2 Form Updated 11/1/10
IBiS TRAVEL AWARD
APPLICATION FORM
Please return both pages of the application with the other application materials to Cathy Prullage in the IBiS office
by noon of deadline date.
Materials to be submitted with the application
1. Travel award application form
2. Copy of the abstract that will be submitted for the meeting.
3. CV including list of publications (include conference abstracts)
Application deadline date (select one) 11/15/10 or 4/1/11 or 7/15/11
Student Name:_________________________________________________________________________________
Daytime phone number______________________________ E-mail address ____________________________
Anticipated date of graduation: _______________ Advisor_____________________________________________
Year
Research topic (or thesis title)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Name of the conference:__________________________________________ Conference Date: ________________
Conference web site:____________________________________________________________________________
I will be (check all that apply): presenting a poster giving a talk
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