Please refer to the travel fund guidelines before completing this application. FOIP The personal information on this form is collected under the authority of the Post-secondary Learning Act and the Freedom of Information and Protection of Privacy Act (FOIP). Your information will be used to administer an Application for Travel Assistance and to contact you regarding this application. Your information will remain confidential and will only be used or disclosed as authorized under FOIP. For questions on the collection, use and disclosure of this information, please contact the University's FOIP Coordinator at 4401 University Drive West, Lethbridge, AB T1K 3M4; email: foip@uleth.ca; tel: 403-332-4620. Your information First name * Last name * E-mail * Conference information Conference name * Conference location * Conference start date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year20222023202420252026 Year Conference end date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year20222023202420252026 Year Is this a scholarly peer-reviewed conference? * Yes No Your role in the conference Conference activity * - Select -Presenting a paperServing as a discussantOther (Explain, note: chairing a session not adequate justification) Other (explain) * Title of paper * List of authors * Attach documentation confirming your role * Upload More informationFiles must be less than 10 MB. Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav rar zip. Funding request Amount requested * $University of Lethbridge guidelines apply for all reimbursements University of Lethbridge Travel Fund (ULTF) * - Select -I have received ULTF funding for this travel (attach documentation)I have applied for ULTF funding for this travelI plan to apply for ULTF funding for this travelI have already exhausted my ULTF funding for this yearI was refused ULTF funding for this travel (explain)I will not apply for ULTF funds for this travel (explain) Attach document verifiying receipt of ULTF funding * Upload More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png txt pdf doc docx rar zip. Explain why you were refused ULTF funding * Explain why you will not apply for ULTF funding * Online signature Online signature * By typing your name you agree that to the best of your knowledge the information entered into this form is truthful and accurate. Leave this field blank Submit