Student Travel Grant Application

Please fill out the entire form below to recommend a student for travel assistance to the 37th International Conference on Plasma Science. Travel grants are available only to those students presenting as a first author and who are IEEE members. If your application is approved, your registration fee will be waived. In addition, you can elect to receive either (a) four nights (Sun-Wed) in the conference hotel in a shared room (double occupancy) or (b) two nights in the conference hotel in a single occupancy room. (The grant committee will arrange same-sex roommates for the grant recipients that choose double occupancy.)

Your Family Name:
Your Given Name:
Hotel stay options:	PLEASE SELECT ONE Four nights free (Sun-Wed) with a roommate; I am male (for roommate assignment)Four nights free (Sun-Wed) with a roommate; I am female (for roommate assignment)Two nights free; no roommate
Your email address:
Your phone number:
Your postal mailing address:
Your IEEE member number:
Will you be attending a short course?	PLEASE SELECT ONE course1course2none
Please provide the title, authors and text of your submitted abstract:
Budget in $US:(airfare, registration, lodging etc.)
Other comments:
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