Student and Early-Career Travel Scholarship

Student and Early-Career Travel Scholarship
The ASA Student and Early Career Travel Fund is supported by member contributions. The purpose of the fund is to encourage students and early-career professionals to become engaged in the statistical community through participation in ASA-sponsored professional meetings.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please confirm you are a member of the ASA*

I am a member of the ASA.
Conference you wish to attend*
Conference Dates*
Have you submitted a conference presentation abstract?*

YesNoYes and it has been accepted for presentation
Do you currently have other support for participation in this conference ?*

YesNo
Eligibility Status*
Highest Degree Field or Emphasis*

BiostatisticsData ScienceStatisticsOther
Provide a brief statement describing your financial need.*
Please share your professional or personal development goals on which you want to make progress through participation in the conference.*
Please provide the name and contact information for a reference with whom you are currently working or have worked.
Reference Name*

First NameLast Name
Reference Email*
example@example.com
Please tell us about yourself.

Optional Demographics
Employment Sector
Gender Identity

ManWomanNon binaryPrefer not to answerAnother option not listed here (please specify):
Race/Ethnicity

American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanHispanic, Latino, Latina, or LatinxMiddle Eastern or Northern AfricanNative Hawaiian or Other Pacific IslanderWhitePrefer not to answerAnother option not listed here
Are you currently a member of a chapter(s)

YesNoNot currently but have been in the past
Are you currently a member of a section(s)

YesNoNot currently but have been in the past
Use this space to provide additional comments you wish to share with the review committee
Thank you!
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