School of Nursing, Midwifery & Nutrition
CONFERENCE ATTENDANCE SUPPORT REQUEST
Name __________________________________________________________________________________________
Phone ________________________________ Email ___________________________________________________
Course (eg. BNSc) _______________________ Year Level _______________________________________________
Conference you wish to attend (please provide the web address as well if possible)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Have you received any funding or support from another source (eg, external organisation)?
_______________________________________________________________________________________________
Have you received any funding or support from the School of Nursing, Midwifery & Nutrition (SNMN) for
conference attendance before? If so, when and how much?
_______________________________________________________________________________________________
Do you have any official capacity at the conference for example, are you a convenor, presenting a paper,
nominated delegate for a student group?
_______________________________________________________________________________________________
What financial support are you seeking from the SNMN (tick all that apply)?
Airfares
Accommodation
Conference Registration
Equipment (for poster or presentation)
All of the above
Other please specify ______________________________________________________________________
What is the estimated total cost of your attendance at the conference? ___________________________________
How much are you requesting from the SNMN? _______________________________________________________
Why do you want to attend this conference? _________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
How do you propose sharing what you learnt at the conference with the School and other students? Outline how
you would do this (eg. written paper, presentation, other).
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Has any absence to attend this conference been permitted/supported by the Course Coordinator or other
academic staff member of the School? If so, which staff member and what have you agreed?
_______________________________________________________________________________________________
Please list any other information you feel is relevant to your application for funding here, or provide extra
information as an attachment.
STUDENT’S SIGNATURE: _______________________________________ DATE: _____________________________
IMPORTANT: Your application will require endorsement by a member of the academic staff of
the SNMN prior to submission to the Head of School. Please submit your completed form to
the appropriate Course Coordinator or other member of the academic staff for endorsement.
ENDORSEMENT - SNMN ACADEMIC STAFF MEMBER TO PROVIDE SUPPORTING STATEMENT:
Signed ______________________________ Name_____________________________ Date___________________
APPROVED
Yes
No AMOUNT APPROVED: $_________ ____________________________________
Head of School signature
Comments:
This form should be submitted to the Head of School’s Office on Level 2 (Room 204) of the Nursing Sciences Bldg, Townsville
Campus, or emailed to nursingmidwiferyandnutrition-office@jcu.edu.au
as soon as possible prior to the conference.
Applications will not be considered after conferences have already been attended. If you are seeking support for airfares
and/or accommodation, please do not make any bookings until you know the outcome of your application.
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