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Student Conference Travel Request
Students requesting travel funding should complete this form. Please email Dr. Lyon with any questions (
lyon@roanoke.edu
).
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
Event (Name of Conference)
*
Your answer
Sponsoring Faculty Member
*
Your answer
Department
Your answer
Destination
*
City, State
Your answer
Departure Date
*
Your answer
Return Date
*
Your answer
Reason for Attending Conference
*
Attendence at Professional Meeting
Presenting Poster
Presenting Paper
Other:
Title or topic of presentation to be made at the conference
*
Your answer
Divison
*
Humanities
Social Science
Science
Other:
Context of Project
*
Summer Scholars
URAP
Class assignment
Independent Study
Honors Project
Research Assistant
Personal project
Other:
I am the _______ on this project.
First Author
Second Author
Third Author
Other:
Clear selection
Will you be presenting this project?
Yes
No, someone else will be presenting for me.
Other:
Clear selection
Registration Fee
Your answer
Estimated Air Fare Cost
Your answer
Estimated Mileage Cost
(auto, at $0.45 per mile)
Your answer
Estimated Lodging Cost
Your answer
Estimated Food Expense
Your answer
Other Expenses
Please explain
Your answer
Estimated Total Cost
*
Your answer
How much $$ can your department allocate to the trip?
Please talk to your department chair
Your answer
Additional Comments or Questions?
Your answer
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