Alain L. de Weck Travel Grant Application Form
Please fill out the information below to submit your application for the travel grant.
Name
*
First Name
Last Name
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Male
Female
Prefer not to answer
Race/Ethnicity (Please select all answers that apply)
*
American Indian or Alaska Native
Asian or Asian American
Black or African American
Hispanic, Latino or Spanish origin
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Other
Current Education or Career Status (e.g. 'PhD Student', 'Postdoc', 'Research Fellow')
*
Country of Residence
*
Did you submit an abstract for the 2027 CIA Symposium? Abstract submission is required to apply for a Travel Grant.
*
Yes
No
Upload a short letter of application, which includes your reasons for applying.
*
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Upload a copy of your abstract.
*
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Upload a letter of recommendation from a supervisor, mentor or colleague who is a current member of CIA.
*
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Upload a copy of your Curriculum Vitae.
*
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Submit
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