Student Virtual Conference Awards

Today's Date*

Student Last Name*

Student First Name*

PID #*

OHIO Email Address*

OMS Year/Status*

Select or enter value

Campus*

Select or enter value

Project Title*

Type of Presentation*

Select or enter value

Conference or Convention Name*

Start Date of Conference*

End Date of Conference*

Primary Faculty Mentor/Advisor*

Primary Faculty Mentor/Advisor Email*

Secondary Faculty Mentor/Advisor (if applicable)

Secondary Faculty Mentor/Advisor Email

Conference Registration Amount*

Total Budget Request*

Maximum of $500

The documents listed below must be attached for your application to be considered.

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 prior to reimbursement. If available at the time of application, please attach here; however, this is NOT required for application submission. Acceptance should include the type of presentation (i.e. podium presentation, poster presentation, etc.) PLEASE NOTE: Incomplete applications will not be reviewed.

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