Graduate Student Association
Travel Grant Application Form
If you have any questions please contact the GSA Travel Grant Committee directly:
gsatravel@ucsc.edu
***Please Type or Print Neatly***
1. Personal Information
Name: ____________________________________
Student Identification Number: ________________
Phone: ____________________________________
Email: ____________________________________
Board/Department (campus address): _________________________________________
Mailing Address (if different than campus address):
_______________________________________________________________________
Years at UCSC as a graduate student: _______
Current degree objective (please circle one): Ph.D. M.S. M.A.
Expected date you will receive graduate degree: __________
2. General Information
Have you applied for a previous GSA graduate student travel grant (circle one)?
Yes No
What previous travel funds have you received from the GSA?
Give amount, date and purpose:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Have you applied to any other campus units for travel funds (circle one)?
Yes No
What is your current source of financial support for your graduate work?
e.g. # of RA/TAships, loans, scholarship, part-time work, others (please explain):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
What other travel support do you currently have? Please indicate amount and source(s):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Last Revised 3/24/08
***Please complete either section 3 or 4***
3. Travel To Conference or Professional Meeting
Meeting you attended: _____________________________________________________
Organization: ____________________________________________________________
Date of meeting: _______________________________________
Location of meeting: ______________________________________________________
Were you one of the presenters at the meeting or conference (circle one)?
Yes No
If yes, Are you the primary author of the presented work (circle one)? Yes No
What was the title of paper/poster/talk you presented?
__________________________________________________________________
__________________________________________________________________
Explanation of expenses you have requested GSA to contribute toward:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. Other Thesis-Related Travel Expenses
Title of Research Project: __________________________________________________
External/Internal Funds available now: ______________________________________
Please describe your plans to seek other possible funding for the current academic year:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Explanation of expenses you have requested GSA to contribute toward:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Note: For thesis-related travel expenses, your faculty sponsor’s statement must clearly state the importance of this particular trip.
Payment will only be against expenses with ORIGINAL RECEIPTS only.
I hereby declare that all the information and statements provided herein are true,
correct and complete to the best of my knowledge and belief.
Signature: ________________________________________________
Date: ______________________________________________
Last Revised 3/24/08