Conference Membership Award
Please use this form to apply for membership cost for academic or professional bodies. You can apply only AFTER having participated and/or attended the conference/event or completing the exam. •Award also covers test, license or certification exams, only if it directly relates to the student's primary academic program. •Each eligible student can use up to $75 for membership cost per fiscal year. •Please note, award is subject to availability of funds.
GSA Name:
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Aerospace Engineering
Anthropology
Architecture
Audiology
Biology
Bio Medical Engineering
Business & Economics
Chemistry
Civil Engineering
Classics
College-Conservatory of Music (CCM)
College of Education, Criminal Justice, and Human Services (CECH)
Communication
DAAP Art Education
Design GSA
English
Electrical Engineering and Computing Systems
Engineering and Computing Education
Environmental and Chemical Engineering
Fine Arts
Geography
Geology
German
Health Sciences
History
Mathematics
Mechanical and Materials Engineering
Nursing
Nutrition
Pharmacy (GAPSS)
Philosophy
Physics
Planning (DAAP)
Political Science
Psychology
Romance Languages & Literatures
Social Work
Sociology Expand
Speech Language Pathology / CSD
Student Occupational Therapy Association
Women's, Gender, and Sexuality Studies
Department:
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Personal Information
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
UC Email:
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M number:
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Conference/Event/Exam details
Award covers academic and professional conference/event as well as test, license or certification exams (only if it directly relates to the student's primary academic program). Please note - You can apply only AFTER having participated and/or attended the conference/event or completing the exam.
Start date of the conference/event/exam
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Month
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Day
Year
End date of the conference/event/exam
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Month
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Day
Year
Name of organization for which membership was purchased OR Name of examination
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Please describe conference/event that you attended and/or participated, or exam you wrote:
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Amount to be reimbursed (up to $75)
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Type the amount you request from GSG
Date of the transaction
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Month
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Day
Year
Date when you paid your membership
Please upload ONE PDF file with: (1) Travel Authorization (if applicable), (2) proof of conference/event attendance or proof of exam completion AND (3) receipt for the requested membership.
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