Date *

MM

DD

YYYY

Name *

First Name

Last Name

Email Address *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Have you received a TWS-MB Student Travel Award in the past 12 months? *

If you select "yes" you are not eligible to apply for this award

Yes

No

SCHOOL INFORMATION

What is your status as a student? *

If you select the third option, you are not eligible to apply for this award

Currently enrolled in a Manitoba College or University

Graduated from a Manitoba College or University within the last 12 months

Graduated from a Manitoba Collage or University over 12 months ago

What College or University are you attending / recently graduated from? *

What degree or diploma are you / were you pursuing? *

Supervisor / Advisor *

Expected Graduation Date / Previous Graduation Dates *

Does your Supervisor / Advisor support your attendance of this conference? *

Yes

No

What conference are you planning to attend? *

Name, location, and dates

Have you submitted your application/abstract to the conference organizers yet? *

Regardless of your answer to the following question, you will need to submit proof of acceptance (when available) to tws.manitoba.chapter@gmail.com with subject line "Student Travel Award"

Yes, and it has been accepted

Yes, but I haven't heard back yet

Other (specify)

What kind of presentation do you plan to give? *

Oral presentation

Poster presentation

Other (please specify below)

What is the subject of your presentation? *

Please insert your abstract below *

If you don't have an Abstract, please provide a short description of what your presentation would cover

Total estimated expenses *

$

Contributions from other sources

$

Outstanding financial need *

$

Amount requested for TWS Manitoba Travel Award *

Maximum of $250

$

If Outstanding Financial Need exceeds Amount Requested from TWS Manitoba Travel Award, how will you make up this difference?

By checking the box below, you are confirming that the information supplied above is true, that the applicant meets the eligibility requirements as stated herein, and that the financial need as stated is accurate.

I agree

In less than 250 words, explain why your contributions to TWS Manitoba and your wildlife research, conservation and management, merits receiving this award ‐ if presenting: abstract of poster or oral presentation and proof of acceptance (when available)