Medical Student Travel Awards

All medical student travel must be in accordance with Ohio University Policy 22.001 (https://www.ohio.edu/policy/22-001) and Ohio University and Heritage College travel policies, procedures, and restrictions.

Today's Date*

Applicant Last Name*

Applicant First Name*

PID*

OHIO Email Address*

OMS Year/Status*

Select or enter value

Anticipated Graduation Year*

Campus*

Select or enter value

Project Title*

Type of Presentation*

Select or enter value

Conference or Convention Name*

Conference or Convention Location*

(City, State, Country if Outside USA)

Primary Faculty Mentor/Advisor*

Primary Faculty Mentor/Advisor Email*

Secondary Faculty Mentor/Advisor (if applicable)

Secondary Faculty Mentor/Advisor Email

Have you applied to a minimum of 2 other sources?*

Select

Budget

Up to $500 for domestic and $750 for international travel; see award guidelines for allowable expenses.

Start Date of Travel*

End Date of Travel*

Conference Registration Amount*

Airfare Amount*

Hotel Estimate Amount*

Name of People Sharing Room*

Mileage Rate ($.67 x # of miles)*

Rental Car Estimate Amount*

Total Requested Budget*

Up to $500 for domestic and $750 for international travel

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: Confirmation of submission or request/screenshot of application confirmation of request for funding from other sources. PLEASE NOTE: Incomplete applications will not be reviewed.

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse