Application: Professional Development BEST Funds
BEFORE
EXPENSES & TRAVEL TAKE PLACE
This form is only for Trainees in the Atlanta BEST Program
LAST NAME:
*
FIRST NAME:
*
EMAIL:
*
Primary Institution
*
Emory University
Georgia Tech
Are you Joint Emory/GT
*
Please Select
yes
no
Are you a US Citizen or Permanent Resident?
*
Yes
No
How did you hear about this opportunity ~Select all that apply
*
Atlanta BEST Program
BEST trainee
Referred by a friend
Your Primary PI/Mentor/Advisor
Faculty- not your PI/Advisor
Poster/Flyer
Information Session
Other
What are you purchasing ?
Type of Purchase ~Select all that apply
*
Conference Registration
Book/Literature
Course (Not-Tuition)
Airfare
Mileage (attach google map)
Lodging
Meal(s)
Other
Company/Organization Author
*
Location: City, State
*
Start Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
List out your budget request in US Dollars
Total Budget Requested:
*
Airfare:
Mileage ($0.57/mile) MUST attach google map with mileage
Number of Miles
Starting location city
Ending location city
Lodging:
Number of Nights
Meal(s): average about $25/day
Number of Days
Other budget amount:
Describe:
Please attach all relevant documentation in one PDF (i.e. itinerary, website pages, invoice, etc)
Attachment:
Select File
Cancel
of
Describe Attachment
Brief Statement: How does this purchase/participation relate to the goals of the BEST program?
*
Additional comments
Submit
Should be Empty: