<p> NCUWM Travel Support Request Form </p><p>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. </p><p>Student Name: ______Student Email Address: ______Faculty Contact Name: ______Faculty Contact Email Address: ______Institution (including address): ______</p><p>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.</p><p>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: ______</p>