Application for Trainee Travel Funds

Name of Trainee:

Position of Trainee:

Department of Trainee:

Address of Trainee:

Phone of Trainee:

E-mail of Trainee:

Name of Mentor:

Department of Mentor:

Address of Mentor:

Phone of Mentor:

E-mail of Mentor:

Name of meeting trainee wants to attend:

Location of meeting trainee wants to attend:

Date of meeting trainee wants to attend:

Name of presentation trainee will make at meeting:

How is this presentation related to diabetes research?

Upload abstract:

Is the trainee making the presentation Yes No

Select the type presentation you intend to make: poster oral presentation other
If "other", please describe:

Date form is submitted