Date *

MM

DD

YYYY

Name *

First Name

Last Name

Email *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

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Have you recieved a TWS Manitoba Student Travel Award or TWS Annual Conference Travel Award support within the last 12 months *

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

Yes

No

SCHOOL INFORMATION

Will you be enrolled full-time at a Manitoba post-secondary academic institution at the time of submitting their presentation for the conference *

If you select "no" you are not eligible to apply for this award

Yes

No

What College or University are you attending? *

What degree or diploma are you pursuing *

Supervisor/Advisor? *

Have you been accepted by The Wildlife Society to present original research?

If you select "no" you are not eligible to apply for this award

Yes

No

What type of presentation do you plan to deliver? *

Oral Presentation

Poster Presentation

What is the title of your presentation *

Please insert your abstract below *

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) *