NCUWM Participant Funding Information

NCUWM Travel Support Request Form

To request student travel support from the Nebraska Conference for Undergraduate Women in Mathematics, the student’s faculty contact should attach this form to an e-mail and send it to [email protected]. Please make the subject line “NCUWM Travel Support Request”. Please remember that most of the student’s expenses during the conference will be covered by the conference.

Student Name: ______Student Email Address: ______Faculty Contact Name: ______Faculty Contact Email Address: ______Institution (including address): ______

Estimated Travel Expenses (Please give exact values if you have them): Good estimates for airfare can be obtained by going to an online travel service such as Orbitz or Travelocity.

Airfare or gas: ______Transportation to and from your local airport: ______Total Estimated Expenses: ______Amount of expenses listed above being covered by your institution: ______Amount of expenses listed above requested from NCUWM: ______