Student Travel Request

Requests are due no later than April 20, 2025 for travel between July 1, 2024 and June 30, 2025.

You should consult with your faculty sponsor about appropriate conference(s) and deadline(s).

Basic Information

Name*

First NameLast Name

Email*

Phone Number

Area CodePhone Number

'Berg ID*

Class Year

Major(s)

Campus Box #

Conference Information

Conference Name*

Write out entire conference name without acronyms

Conference Address*

Street Address

Street Address Line 2

CityState / Province

Faculty Sponsor*

Conference Date(s)*

Presentation

Has your proposal been accepted yet?

Have you submitted this work to more than one conference?

Please explain

A typed abstract of the appropriate length for the conference – usually 250 - 500 words – should accompany this request.

Include the title of the presentation. If there are multiple authors, please indicate all authors and actual presenter(s).

Title

Abstract

Author(s) (place an asterisk* next to presenting authors)

Expenses Information

Is this request for Travel Only? *(No Presentation)*

Typically travel only will not exceed $100

Anticipated Expenses:

Housing (If sharing, list your portion)

# nights * $ per night

Transportation

Conference Registration

Food

Other

Total Travel Expenses

Anticipated Funding:

Funds from other sources

Total Funding from Other Sources

Total:

Total Requested

total requested = total expense - total funding

Verification

I certify that this project meets expected standards for this conference and that the project has already been completed or will be completed before the conference.

Upon completion, your faculty sponsor will receive this form to sign.

Faculty Sponsor Email*

Today's Date*

Date

Signature*

Student Travel Request

Student Travel Request Verification