Global Health Funding Request Application
The Global Health Program encourages outstanding Global Health students to present their research papers and projects at educational and professional conferences.

Application Details:
Applicants must be current UC San Diego students at the time of the conference/event attendance, Proof that the paper/project has been accepted by the conference must be included with the application, and students must apply for, and be approved for, funding before attending the conference.

*Please note that funding will be awarded via reimbursement; receipts must be submitted to the Global Health Program after the applicant attends the conference.

First Name *
Your answer
Last Name *
Your answer
UCSD Email Address *
Your answer
Primary Phone Number *
Your answer
I am a: *
Required
Anticipated Quarter of Graduation *
Your answer
Name of Conference *
Your answer
Date of Conference *
MM
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DD
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YYYY
Location of Conference *
Your answer
Description of the Conference *
Your answer
Conference Website Address *
Your answer
Title of Paper/Project *
Your answer
Description of Paper/Project *
Your answer
Are you working with any faculty for this project? If so, who? *
Your answer
Explanation of why you would like to attend this conference *
Your answer
Explain what educational/professional benefits you would receive by attending the conference *
Your answer
Have you received any other funding to attend this event? If so, from who and what amount?
Your answer
How much funding are you requesting from GHP and what for? *
Your answer
Electronic Signature (I hereby certify that all information reported on my application is true and complete to the best of my knowledge.) *
Your answer
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