Transit Stipend Request Form

Transit Stipend Request Form

These are issued only to cover expenses for students who must use public transportation to get from their accommodations to their classes or for any travel as part of a course requirement which is not covered by the program. In some instances (especially in London or other large cities), taking public transportation may not expedite a student's journey to and from classes, in which case a stipend will not be issued.
Name*

First NameLast Name
Email*
99 Number*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Program Start Date*

MonthDayYear
Date
Program End Date*

MonthDayYear
Date
Term Break Start Date*

MonthDayYear
Date
Term Break End Date*

MonthDayYear
Date
Number of weeks in the term/semester, less breaks*
Does your program/host institution offer any assistance with transportation costs?*
Do you have the option of obtaining a monthly pass or student discount?*
If yes, please give details:
What mode of transportation will you be taking (bus, subway, bike rental)?*
Please provide the details of your details of your commute (i.e. amount of time it takes to walk vs. taking public transportation, any additional course requirements that involve transportation, class schedule (frequency, night classes)).*
How much money (in local currency) will you spend each week?*
How much money (in US dollars) will you spend each week?*
Total amount (in US dollars) requested*
Is there any additional information that should be taken into consideration regarding this request?
Should be Empty: