MD Student Travel Scholarship Request

The UW School of Medicine and Public Health provides funding for MD students to travel to conferences through various programs. UW-Madison MD Students may request support for travel from academic programs through this form. Request for conference travel support through Medical Departments should be directed to the individual department.


UW policy determines how SMPH can provide support for student travel. Travel awards issued to a student for the student’s personal or academic benefit must be processed as scholarships. Students should consult with the Office of Student Financial Aid before accepting an award for travel to determine if their financial aid award will be affected by the scholarship.


Travel support is NOT guaranteed. Each program will determine eligibility through program guidelines.


Students must request and receive permission from the Dean for Students (or their designee) and their course directors to be absent from any part of required learning activities (small groups, labs, etc.).

Select
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MD Program Year*
Phone
Student Organization Membership*

Select the Student Organization which relates to the travel being requested.

Agree*

I attest that I am a meaningfully involved member of the selected OMA-HPL affiliated student organization. If applicable, I further attest I have paid necessary dues to the national/regional chapter of my selected OMA-HPL affiliated student organization.

Please provide the name of the conference, location, and official conference website.

Travel by air shall be limited to the lowest, logical, non-refundable, coach/economy class fare available. The additional cost for premium class or seat assignment fees for premium class is not reimbursable (first class, business class, economy plus or economy comfort).

The University will pay or reimburse actual lodging costs, within the stated maximum rates for the location, when the trip requires an overnight stay. Lodging payment/reimbursement is limited to the maximum single/standard room rate. Lodging maximums are calculated based on location. Visit the UW TravelWise rate calculator to view rates for your travel destination.

Registration fees for official participation at conferences, conventions, training, or meetings related to University business are payable/reimbursable.

Rideshare and taxi services are acceptable travel expenses in transit to and from your arrival location and conference. Rideshare and taxi services for personal purposes are not allowable.


UW Driver Authorization is required before driving any vehicle on official UW business - driving expenses cannot be reimbursed without prior UW driver authorization.


When it is determined that a rental vehicle is the most cost-effective means of transportation, use of contract rental vehicle suppliers is required.


For further details, see UW Vehicle Use/Rental Policy, including information regarding mileage calculations.

When a traveler is expected to incur costs for meals and incidentals for overnight business travel, the University will reimburse meal and incidental expenses (M&IE) under a per diem allowance. Meals included as part of the conference are not eligible for reimbursement. The UW TravelWise rate calculator is the official source for obtaining lodging and M&IE Per Diem rates prior to travel.

UW Madison Travel Planning and Policies

Additional Funding*

Have you received, or do you plan to receive, additional funding from another UWSMPH Department or affiliate for this travel?

Student Attestation - Policy and Guidelines*

I certify that I have read and understand the Office of Multicultural Affairs for Health Profession Learners travel guidelines, UW-Madison Travel Policy, and MD Program Student Handbook.

Student Attestation - Academic Standing*

I attest that I am in good academic standing.

Photo and Video Release*

In addition to your professional development, we hope your presence and representation of UW-SPMH will help recruit the next generation of talented and compassionate students. We would greatly appreciate you providing us with photos and/or video of your presence at the conference for promotional materials. If you are willing to do so, please review the photo and video release and indicate your consent below.


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