First2 Travel Application Request
The First 2 STEM Success Network NSF INCLUDES Alliance award includes travel funding for participants:
-To get more people to existing gathering spaces such as Undergraduate Research Day at the Capitol or West Virginia Academy of Sciences annual meetings, (please let us know about others!)
-To take “field trips” to observe STEM success work going on at other sites, and
-To gain information to bring back and strengthen the network, use of Networked Improvement Communities (NIC), and support for STEM students.

First name *
Your answer
Last name *
Your answer
Email address *
Your answer
Phone number *
Your answer
What is the purpose of your travel? How does this travel support the First 2 Network Alliance aims? *
Your answer
What is the event you are attending? *
Enter the approximate total amount of travel support requested from First2 Network for this event *
Your answer
Are you traveling with students? (This will make you in some sense a chaperone for the trip.) *
If students are traveling with you, please list their names. If they need travel support also, please have them submit their own forms.
Your answer
Starting point (City, State) *
Your answer
Destination (City, State) *
Your answer
Departure date *
MM
/
DD
/
YYYY
Departure time (estimated). This determines what meals can be supported. *
Your answer
Return date *
MM
/
DD
/
YYYY
Return time (estimated). Again, this time determines what meals can be supported. *
Your answer
Lodging (please specify the number of nights under "Other" if more than 2 nights are requested.) Where possible we prefer to pay your hotel costs directly. *
If registration costs are requested, explain and give the total cost under "Other." *
If you are driving your personal vehicle and mileage reimbursement is requested, list the TOTAL number of miles you will drive on the blank for "Other". If you are making a round trip, be sure to add the miles you drive each way. *
If a rental vehicle is requested, use the "Other" line to explain briefly and give the quoted total cost for the rental (e.g., 6-passenger van from Enterprise, $180 for three days) *
If a rental vehicle is requested, use the "Other" line to explain briefly and give the total anticipated fuel cost. (e.g., 150 mile trip, gas total ~$12 ) *
If airfare is requested, use the "Other" line to explain briefly and give the quoted total cost for the airfare. *
List the number of each type of meal for which you are requesting support (e.g., 0 breakfast, 1 lunch, 1 dinner) *
0
1
2
3
4
Breakfast
Lunch
Dinner
Have you submitted a First2 Travel Application Request within the past year? *
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