Executive Mentor Program Travel Grant Application

Executive Mentor Program Travel Grant Application The Executive Mentor Program will reimburse a student up to $750.00 in travel expenses (airfare, mileage, ground transportation, and/or lodging) to visit their executive mentor. This opportunity for travel reimbursement applies only to students who have an executive mentor residing 250 or more miles outside Manhattan, KS and not in the student’s hometown.

Contact Information Name WID Street Address (permanent) City, State ZIP Phone E-Mail Address

Travel Plans Destination (City, State) Dates of proposed travel

Travel Expenses For which expenses are you applying to be reimbursed?

Airfare Mileage to/from destination ($0.30/mile, in lieu of airfare - when driving is more cost/time efficient than flying) Ground transportation from airport to hotel/executive mentor’s office (i.e., taxi, bus, train) Lodging

Estimated Expenses: Airfare $ Mileage # miles x $0.30/mile = $ Ground transportation $ Lodging # nights x $ per night = $ Total expenses $ Please attach supporting information, such as sample flight itinerary and cost info from airline website, map of mileage to/from destination, and/or estimated cost from hotel website.

Executive Mentor Contact Information Name Phone E-Mail Address Please have your mentor provide a letter of support (attached to this application or sent via email to Emily Brueseke at [email protected]) indicating that s/he is aware of and in support of your visit.

Agreement and Signature By submitting this application, I affirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that submitting an application is no guarantee that I will be awarded travel money to visit my mentor. If I am awarded a travel grant, I understand that the money will be provided to me in the form of a scholarship that will be deposited into my student account after travel has been completed. I acknowledge that Kansas State University is not involved with and does not supervise, arrange, or otherwise control the travel or other mentor visit logistics, which are solely my responsibility.

Name (printed)

Signature

Application Review Process Applications will be reviewed on an on-going basis throughout the academic year and travel grants will be awarded until all money for the year has been distributed.

Completed applications should be submitted to Emily Brueseke, Director of the Executive Mentor Program (K-State Alumni Center, 3rd floor, Information Services suite).

Upon receipt of your complete application, you can expect to receive a response within five business days with instructions on how to proceed if your request is approved. Please be aware that approved travel will be reimbursed in the form of a scholarship that will be deposited into your student account. Student travel scholarships will be awarded AFTER travel has taken place and are contingent upon submission of all associated travel receipts to the Executive Mentor Program. Students will also be asked to provide a brief statement about how they benefitted from the opportunity to visit their executive mentor.

If you have questions, please contact Emily Brueseke (785-532-3661, [email protected]). Thank you for your application!