Application for Scholarly Presentation
Travel Assistance Award
Date:
Department:
Student ID Number:
Student Name:
College:
Degree Program:
Name of Conference:
Location of Conference:
Applicant’s Signature:
Chair Signature:
Email or letter of acceptance is required with this application. Form must be submitted to Nikki Adams (nadams@astate.edu)
after electronic signatures are completed. Please ensure any relevant additional documentation is attached to the generated
email.
Itemized projected travel expenses (airfare, registration fees, lodging, meals, mileage, etc.):
For Ofce Use Only
I approve this student’s application for a Scholarly Presentation Travel Assistance Award. My department will contribute the
following amount toward the travel expenses of this student.
Conference Sponsor:
Title of Presentation:
Departmental Contribution:
Proposed Travel Dates:
Student Email Address:
Date:
SUBMIT
SUBMIT
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