Travel Award Application

Awardees must present a poster, abstract, or invited talk in order to be eligible for this award. Also, applicants must pursue alternative funding for travel. All reasonable efforts should be made to complete the application at least 60 days prior to the date of departure.

Today's Date

Amount of Funding Requested ($1,000 max)

Applicant Information

First Name

Last Name

Email

Phone

Year in Medical School

Mentor Information

Mentor's First Name

Mentor's Last Name

Mentor's Email

Mentor's Phone

Specialty, department or field

Academic Rank

Travel Description

Travel Dates

Conference Name

Conference Dates

Conference Location

Travel Summary - Describe briefly: 1) the conference that you are attending and 2) the research that you are presenting as a poster, abstract and/or invited talk, (max: 1500 characters).

Abstract - Please paste your abstract here.

Budget Expenses: Provide estimated expenses for each category. The total combined for all expense categories should equal the total amount requested.

Conference Fees

Air and Ground Transportation

Lodging

Meals

Total

Describe Alternative Sources of Travel Funding That You Applied For

Agreement

Funding awards have reporting and programmatic requirements. These requirements include submitting a final project report and a poster presentation (or talk) of your research to the Medical Student Research Committee. This submission should be within two weeks of returning from the conference. Also, awardees must acknowledge the support of the USD Sanford School of Medicine Medical Student Research Program in any presentation or publication involving the sponsored research. By checking this box, I confirm that I will agree to adhere to the reporting and programmatic requirements if my project is funded.

What is your role at the conference (Presenting Author, etc.)?

What is your role in this research project?

Are there any other medical students on this project?

Are you planning to attend this conference whether you are funded or not?

How does attending this conference benefit the Sanford School of Medicine?

Travel Award Application

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