Form

Individual Travel Grant Application

Through the Research Student Council
The GAPSA Research Student Council distributes individual travel grants to defray the cost of qualified travel expenses for graduate students presenting their research at academic conferences and meetings. Applicants are expected to have considered all other possible funding options before pursuing funding through a GAPSA travel grant . Students attending international conferences or high impact conferences with large estimated budgets (greater than $1000) are encouraged to apply for the President’s Award.
DISCLAIMER!!!

Read and understand all guidelines supplied on the GAPSA website before submitting!

This application is subject to the rules and guidelines set forth in the GAPSA constitution and

on the GAPSA website.
I. Personal Information:
Full Name*
First Name Middle Initial Last Name
UPenn E-mail Address*
A valid UPenn e-mail

Mailing Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

School*
Department
Graduate Group*
Are you a full time student?*
What degree are you currently pursuing?*
II. Applicant Travel Grant History
Have you previously been reimbursed for a GAPSA Individual Travel Grant?*
Review Period of latest reimbursed individual travel grant.*
Review Period
....*
Year
Review period you are applying for:*
Review Period
Year you will be applying for:*
Year
Are you also applying for the President's Award this review period?*
III. Outside Funding

Have you applied for travel funding from any source other than GAPSA?
Source #1*
Amount #1*
U.S. Dollars ($)
Status*
Another source?*
Source #2*
Amount #2*
U.S. Dollars ($)
Status*
Another source?*
Source #3*
Amount #3*
U.S. Dollars ($)
Status*
Another source?*
Source #4*
Amount #4*
U.S. Dollars ($)
Status*
If you answered 'None of the above', please, explain why.*

0/100
IV. Qualified Travel Expenses

Be as specific as possible. See Individual Travel Grant through the Research Student Council guidelines for details on permitted expenses (e.g. GAPSA will not reimburse for meal expenses incurred during conference travel). If you will not incur an expense in one of the categories please mark '0.00'.
Registration Fees*
U.S. Dollars ($)
Total Lodging Costs*
U.S. Dollars ($)
Daily Lodging Rate*
U.S. Dollars ($)
Days*
Transportation #1*
U.S. Dollars ($)
Transportation Mode*
Mode
Other Transportation Costs?*
Transportation #2*
U.S. Dollars ($)
Transportation Mode*
Mode
Other Transportation Costs?*
Transportation #3*
U.S. Dollars ($)
Transportation Mode*
Mode
Other Costs*
U. S. Dollars ($)
Total Estimated Travel Costs (sum all the costs you entered above)*
U. S. Dollars ($)
Describe your efforts to reduce cost:*

0/250
V. Conference Information
Conference Title*
Conference End Date*
Month Day Year
Conference Start Date*
Month Day Year
Conference Location*
City
....*
State/Province
....*
Country
File that verifies conference information e.g. a pdf of conference web page.*
What is the importance of this conference for your professional and academic development?*

0/250
VI. Presentation Information
Presentation Type*
Proposed Title*
Proposed Abstract*

0/750
A copy of the letter from the conference organizers accepting your bid to present your research. (If your abstract has not yet been accepted by the time you submit your online application, submit a file explaining this. Your application will be put on "Conditional" status until you send proof of abstract acceptance to gapsa.research@gmail.com. Write in the subject line: "Abstract Acceptance Update: Your First & Last Name".)*
VII. Terms of Agreement

I, the applicant, affirm that all the above information is true and correct. I have read the guidelines and requirements and understand that it is my responsibility to abide by them. I understand that final reimbursement is conditional and subject to verification of expenses via original receipts, to international tax agreements, to GAPSA paperwork deadlines and to final approval. I also declare that if any of the above information changes between now and reimbursement, I will notify the GAPSA Vice Chair for Research Students immediately.
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By typing my name and initials below, I am signifying that I understand and agree to the above statement.
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Digital Signature*
First Name Last Name
Initials*
PennCard Number*
Enter validation text as shown*
Note that your IP Address and the date and time will be recorded upon application submission. ONLY ONE SUBMISSION PER IP ADDRESS
N.B. Your application is NOT considered complete unless and until you submit a letter of reference. Electronic letters are preferred and should be sent to gapsa.research@gmail.com. Paper letters may be sent to: Travel Grant Application, GAPSA Research, Graduate Student Center, 3615 Locust Walk, University of Pennsylvania, Philadelphia, PA 19104-6221
Should be Empty:

Individual Travel Grant Application

I. Personal Information:

II. Applicant Travel Grant History

III. Outside Funding

IV. Qualified Travel Expenses

V. Conference Information

VI. Presentation Information

VII. Terms of Agreement

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