Conference Funding Application Form
Student Information
Salutation:
Mr.
Ms.
Mrs.
First Name
Last Name
College
CIS
EEE
CJ
COE
BOUVE
LAW
BA
Arts and Sciences
Program (could be the same as college)
Degree Program
PhD
MS
MA
JD
Full Time or Part Time
Full Time
Part Time
Advisor Information
Advisor's First Name
Advisor's Last Name
Advisor's e-mail address
Advisor's Office Telephone Number
Advisor's Office Address (building and room #)
Contact Information
MyNEU e-mail address (will become your login)
E-mail address you can be reached at
Local phone number
Mailing Address
Street and apt.
City
State
Zip Code
Budget Request
Have you applied for GPSA Conference Funding this Academic Year?
Yes
No
Have you received GPSA funding in the past years?
Yes
No
Are you presently a financial aid recepient (NUTA, scholarship, SGA stipend, grant)?
Yes
No
Budget Item
Requested Amount in $ (should NOT exceed $300)
Airfare
Train
Bus
Rental Car
Lodging
Registration Fee(Conference/Seminar)
Airfare
Train
Bus
Rental Car
Lodging
Registration Fee(Conference/Seminar)
Airfare
Train
Bus
Rental Car
Lodging
Registration Fee(Conference/Seminar)
Airfare
Train
Bus
Rental Car
Lodging
Registration Fee(Conference/Seminar)
Airfare
Train
Bus
Rental Car
Lodging
Registration Fee(Conference/Seminar)
Total:
Conference Information
Conference Name/Title
Location (city, State)
Conference Sponsoring Organization Name (University, etc.)
Web Address of the Conference
Conference Start Date
Month
Date
Year
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2007
2008
Conference End Date
Month
Date
Year
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2007
2008
Are You a Speaker
Yes
No
Describe sources of funding and why the department is not funding you:
IMPORTANT
The amount you requested should not exceed $300 in total.
Receipts:
Before preparing your application, please note that graduate student applicants must budget their event or activity. For planning purposes, the GPSA requires that you detail your planned expenses in advance of your activity and outline those expenses on the Itemized Receipt Worksheet portion of the application form. Without a budget, your application will be denied.
KEEP YOUR ORIGINAL, ITEMIZED, PERSONALIZED RECEIPTS. Without qualifying receipts your reimbursement will be denied. Receipts must be:
Original – Not photocopied
Dated – Contemporaneous with your event or activity
Personalized – Addressed to you, the applicant, by a named issuer
Itemized – Stating specific item(s) purchased
Quantified – Showing U.S. dollar amounts
Valued – Exhibiting words in evidence of payment to the issuer
No An electronic airplane ticket e-mail confirmation is not a receipt (the applicant must have a boarding pass and payment information).
No A receipt issued to a third party will be denied.
No Receipts cannot be shared between applicants.
No Bank account and credit card statements are not receipts unless submitted with proof of related purchase.
THE FUNDING PROGRAM DOES NOT REIMBURSE FOOD OR BEVERAGE PURCHASE. RECEIPTS FOR THESE ITEMIZED PURCHASES WILL BE REJECTED
Yes An airplane ticket receipt with purchase information and the boarding pass is a receipt.
Yes A canceled check issued to an individual and showing the name and address of the applicant in the top left corner is a receipt if used in conjunction with a copy of a receipt issued to that other individual. For example, your friend paid for your expense and you issued a check to your friend. That canceled check and the receipt issued to your friend as per the above criteria is a suitable receipt.
Check this box if you have read the submission agreement