Funding Resources Name* First Last PeopleSoft Number and NetID* What would you like funding for?*Choose oneAcademic ConferenceEducation AbroadResearch OpportunityOtherPlease describe the research opportunity*Please describe what you would like funding for*Conference Name* Education Abroad Name* Conference Dates* Education Abroad Dates* Conference Location* Education Abroad Location* Registration Deadline* Registration Fee* Tuition Fee* Housing Fee* Cost of Meals (not provided with registration)* Travel Fee* Other Fees Other funding sources you have applied for Personal Contribution* Total LSAMP Funds Requested* Central to our mission is conducting research. Please explain what research opportunities you will have while abroad.*Justification for spending LSAMP funds: What benefits (personal, academic, professional) will you gain through participation in this event?*What LSAMP activities have you participated in or plan to participate in?*Please include any other pertinent informationPlease include any necessary filesMax. file size: 2 MB.CaptchaNameThis field is for validation purposes and should be left unchanged.