Student Travel Support Form

Please fill in the Contact Information form below and include the amount of your funding request in the Comments text area. Be sure to fill out the simple human verification test and click the Submit button at the bottom when you are finished.

I hereby request travel assistance from the Canadian Geophysical Union (CGU), in order to attend this year’s annual meeting. I certify that I am a student member of CGU, and I will be the primary author and presenter of a paper (oral or poster) at the above-mentioned scientific meeting. I understand that the level of funding will be determined by the CGU.

 

Title *


First Name *

Last Name *

Supervisor Name *

University *

Department *

City *

Province / State *

Postal Code / Zip Code *

Phone (include area code) *


Email *

Program *
 BSc MSc PhD Other

Please fill if you clicked 'Other'

CGU Member Number *

Comments

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