IEEE BRAIN Travel Support Application for INTERMAG 2024

IEEE BRAIN Travel Support Application for INTERMAG 2024
Name*

First NameLast Name
IEEE Membership Number (Required)*
Email*
example@example.com
Confirm Email*
example@example.com
Institute/Company *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Type of Degree (Ph.D., or M.D., or M.S., or B.S.)*

Ph.D.M.S.M.D.B.S.
Thesis Title *
Thesis Description (500 word max)
Advisor Full Name*
Advisor Email*
Advisor Confirmation Email *
Advisor Institute*
Advisor IEEE Membership Number (required)*
Conference Digest Number *
Conference Digest Title*
Travel Expense Budget Information*
Airfare/Driving
Lodging
Food
Have you received any previous IEEE Magnetics Society Conference Travel Awards (Eg. Intermag, MMM, TMRC or ICM)*

YesNo
I agree to write a brief account of my experiences at the conference for possible inclusion in the IEEE Magnetics Society Newsletter or IEEE BRAIN Newsletter.*

YesNo
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