Travel Grant Application
Student Name
*
First Name
Last Name
BGSU Student ID number
*
Email Address
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
(000) 000-0000
Current Class Standing
*
Please Select
Freshman
Sophomore
Junior
Senior
Major/Minor
*
Current Cumulative GPA
*
Anticipated Date of Graduation
*
-
Month
-
Day
Year
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Faculty Mentor Name
*
First Name
Last Name
Faculty Mentor Email Address
*
example@example.com
Faculty Mentor Phone Number
(000) 000-0000
Department
*
Department Chair
*
First Name
Last Name
Department Chair Email Address
example@example.com
College
*
College Dean
*
First Name
Last Name
College Dean Email Address
example@example.com
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Name of Conference/Exhibit/Performance/Competition
*
Location
*
Start Date
*
-
Month
-
Day
Year
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End Date
*
-
Month
-
Day
Year
Date Picker Icon
Title of Presentation
*
What type of conference/exhibit/performance is this?
Please Select
Local/State
Regional
National
International
Estimated Number of Attendees
*
Were submissions peer-reviewed?
*
Yes
No
N/A
Was your submission invited/solicited?
*
Yes
No
N/A
Is your exhibit or performance juried?
*
Yes
No
N/A
Was the research/scholarly/creative activity on which your presentation/exhibit/performance/competition is based supported through CURS?
*
Yes
No
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Registration
Estimated Expenses (enter $0 where not applicable)
Transportation
*
Accommodations
*
Meals
*
Other (specify category and amount)
*
Amount of Requested Support from CURS
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Do any BGSU departments endorse you? If yes, who?
*
Endorsement Amount
Do any BGSU colleges endorse you? If yes, who?
*
Endorsement Amount
Please identify any other sources from which travel funds have been requested/provided.
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Attach Faculty Mentor Support Letter
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Letter of Acceptance from the Conference/Exhibit/Performance/Competition
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