INTERMAG Child Care Support Application Form

Child Care Support Application

Submission Deadline: January 25, 2026
Personal Information
Name

First NameLast Name
Company/Institution
Address

Street Address

Street Address Line 2

CityState

Zip Code
Country
Email
example@example.com
Confirm Email
example@example.com
Number of Children
Ages of Children
Career Information

Other
I have submitted a digest to present at the INTERMAG 2027 Conference.
Digest Submission # (control ID) or Digest ID (AA-01, AP-01, etc.)
Funding Information - Please check ALL that apply
Where is the provider traveling to/from?
Where will the children be cared for (city/state/country)?
Where is the provider travelling from?
Please explain necessity in more detail
Additional comments
Should be Empty: