Department of Communication -- Graduate Student Travel Support Request

Submit this completed form to the Graduate Program Coordinator (Ceccarelli) in hard copy.

NAME: DATE:

CONFERENCE (FULL NAME):

DATES OF CONFERENCE:

LOCATION:

EXPECTED TRAVEL DATES AND TIMES: Departure Return

Date Date

Time Time

If the department is making the flight reservation on your behalf, flight numbers are needed.

ESTIMATED COSTS Registration:

Transportation:

Lodging:

Other:

TOTAL:

Title of paper(s) to be presented	Group / division	Type of submission
1.	1.	1a. Paper ___ Abstract ___ 1b. Submitted as part of an organized panel? Y___ N ___
2.	2.	2a. Paper ___ Abstract ___ 2b. Submitted as part of an organized panel? Y___ N ___
3.	3.	3a. Paper ___ Abstract ___ 3b. Submitted as part of an organized panel? Y___ N ___

List all travel funding received from the department since July 1 (indicate date, conference and amount received):

If you have received departmental travel support before, please indicate the status of those conference papers:

1. Which have you submitted for publication? Title and journal to which submitted:

2. Outcome?

3. If accepted for publication, please give publication date.

CHECKLIST: ____ Have faculty member (___________________) sponsoring your travel email GPC.

____ Include hard-copy submission with travel request.

____ Include hard copy of acceptance letter.

Department of Communication use:

Recommended Not recommended Date GPC initials

$ Budget Date Chair initials

Revised September 2007