DI Student Travel Award

Date of Application

Applicant Last Name

Applicant First Name

PID #

OHIO Email Address

Year

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Campus

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Project Title

Type of Presentation

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Conference or Convention Name

Conference or Convention Location

Dates of Travel

Primary Faculty Mentor/Advisor

Primary Faculty Mentor/Advisor Email

Secondary Faculty Mentor/Advisor (if applicable)

Secondary Faculty Mentor/Advisor Email

Requested Budget

Up to $400 for domestic and international travel; see award guidelines for allowable expenses.

Conference Registration Amount

Airfare Amount

Hotel Estimate Amount

Names of People Sharing Room:

Mileage Rate ($.535 x # of miles)

Rental Car Estimate Amount

Total Requested Budget

The documents listed below must be attached for your application to be considered. PDF files are strongly encouraged as formatting can change between platforms when Word (or similar) files are used.*

1. Abstract: A copy of the abstract that was submitted to the conference. Please include the full author list and the type of presentation (podium presentation, poster presentation, etc.) 2. Acceptance Notification: A confirmation of your acceptance from the conference or convention where you will be presenting is required. Acceptance should include the type of presentation (i.e. podium presentation, poster presentation, etc.) 3. Verification of Application to Other Sources: Email confirmation of submission or request/screenshot of application confirmation of request for funding from other sources.

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