Application for STUDENT Travel
Name: __________________________________________________________
Student Number: E__________________________ Email address: __________________________________@emich.edu
School: Engineering Technology Information Security & Applied Computing Ph.D.
Technology & Professional Services Management Visual & Built Environments
Conference/Workshop: ____________________________________________________________________________________________________________
Location: _____________________________________________________ Dates: Depart: ___________________ Return: ______________________
Budget Summary: Airfare: ______________________ Mileage: ___________________________
Lodging: ______________________ Conference Registration: ______________________
Meals: ________________________ Taxi/etc: ______________________
Amount Requested: ___________________________________________
Signatures:
Applicant: ____________________________________________________________________________ Date: __________________
Faculty Sponsor: ____________________________________________________________________ Date: ___________________
School Director: _____________________________________________________________________ Date: ___________________
Dean: _________________________________________________________________________________ Date: ___________________
Please indicate your participation: Presenting a Paper Presenting a Poster
(check all that apply)
Participating in a Panel Discussion Other: __________________________
Please attach to this application a typed abstract of your presentation and your responses to the following:
1. General format and content of the conference and/or workshop.
2. Sponsor and student participation (presentation, poster, panel discussion, other).
3. The potential contribution of this presentation to your field or discipline.
4. Value of this meeting to the professional development of the student and visibility of the College.
Please include a signed letter of support from a faculty sponsor.
OFFICE USE ONLY: Approved for Funds: School: $_______________ Dean: $_____________