Travel and Professional Development Grant Application Form

Full Name

Applicant's E-mail Address (must use full Columbia e-mail address)

Department/Institute (e.g. Anthropology, MESAAS, Statistics, etc.)

Have you ever previously received an ASGC or GSAC Travel and Professional Development Grant?

Yes

Presentation Title

Name of the Conference (which the grant would support you attending)

Location of the Conference (City, State, & Country)

Start Date of the Conference (the first day that you would attend)

Justification for financial assistance, including how your attendance will enhance your career development (300 word limit)

When did you receive your acceptance notification? (The acceptance mail/scanned letter from the conference has to be emailed to [email protected]; your application will not be considered complete without receipt of the acceptance letter)

Will costs of this trip be covered by other funds besides ASGC Travel Grant? If yes, please provide the contact(s) name and email of your other funding source(s).

Total amount requested from ASGC? ($500 maximum)

The following questions are merely used to gather information on graduate student travel grant needs and will not impact the status of the application. Travel costs

Accommodation costs

Registration costs

Other costs

How many GSAS matching grants have you previously received?

Percentage of departmental travel grants used

Full Name of Reference (who supports your application for the ASGC travel and professional development grant and who can certify that the work is a significant contribution to the field and is related to your research objectives).

E-mail Address of Reference

By signing my full name below, I affirm that all the information herein is true and correct. I have read the guidelines and requirements and understand that it is my responsibility to abide by them. I understand that an incomplete or incorrect application will be rejected. I understand that final reimbursement is conditional and subject to verification of expenses via original receipts, to international tax agreements, to ASGC paperwork deadlines, and to final approval. I also declare that if any of the above information changes between now and reimbursement, I will notify the ASGC Budget and Finance chair immediately.

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Travel and Professional Development Grant Application Form

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