LACIS Faculty Travel Grant Application

Name*
First Last
Department*
Meeting to be Attended*
Beginning Date of Meeting*
MM slash DD slash YYYY
End Date of Meeting*
MM slash DD slash YYYY
Location*
Title of Paper to be Presented*
Proposed Travel Budget
Transportation*
Food, Lodging, Maintenance and Miscellaneous*
Total*
Are you eligible/have you applied for departmental funds for this meeting?*
- Yes, I am eligible
- No, I am not eligible
- Yes, I have applied
- No, I have not applied
Please select all that apply
Please explain:
Are you eligible/have you applied for Graduate School funds for this meeting?*
- Yes, I am eligible
- No, I am not eligible
- Yes, I have applied
- No, I have not applied
Please select all that apply
Please explain:
Have you received LACIS travel funds in the past 5 years? If so, give dates and amount of award*
Briefly explain how this project will further your research*
Briefly describe the potential audience of the project, the potential for dissemination and the prospects for publication of written work*
Additional Information
In this section you may attach/add any additional information pertinent to the application.
Attachment 1
Accepted file types: jog, png, pdf, doc, docx, mp3, wav, Max. file size: 2 MB.
Files must be less than 2 MB. Allowed file types: jpg png pdf doc docx mp3 wav.
Attachment 2
Accepted file types: jpg, png, pdf, doc, docx, wav, Max. file size: 4 MB.
Files must be less than 4 MB. Allowed file types: jpg png pdf doc docx mp3 wav.
Web Page
Email Address*

Proposed Travel Budget