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Division of Academic Affairs

Academic Affairs | Jackson State University > Travel Grant Application

Travel Grant Application

Name *

JNumber *

Academic Rank *

Please indicate your employment status

9-month employee
12-month employee

College or School

Department

Email *

Phone Number

Event Name *

Event Description

Event Location (City and State) *

Presentation Title *

Has your abstract or presentation been peer reviewed? *

Yes
No
Not sure

Is your abstract, paper, or presentation authored with a JSU graduate student?

Yes
No

What is the name of the graduate student(s) co-author(s)?

Beginning date of travel *

End date of travel *

Registration fees *

Travel by *

Lodging Cost *

Cost to travel to event *

Other travel expenses (taxi, Uber, shuttle, etc.) *

Total amount requested *

Acceptance Letter/Preliminary Conference Program

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Paper or Presentation

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Lodging Estimate/Reservation

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Conference Registration Materials/Instructions

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Airfare, Train Ticket or Bus Ticket Estimate or Mileage Map

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Additional Information

The applicant agrees that (1) this request is not complete nor actionable until the Division of Academic Affairs receives a copy of the acceptance letter or preliminary conference program indicating his or her participation and documentation for any requested funds (e.g. conference registration schedule showing costs, lodging estimate or reservation, mileage map or transportation ticket or estimate); (2) if approved, he or she will return the Travel Request Form signed by the applicant and his/her chair to the Division of Academic Affairs for receipt of signatures of the Faculty Development director and the Title III director; and (3) if approved, he or she will return the signed Travel Request Form to the Division of Academic Affairs before the date of travel or fifteen (15 days) before the conference registration deadline and date of travel for applicants seeking registration pre-payment. *

Applicant agrees

File Upload

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Jackson State University

1400 J.R. Lynch Street

P.O. Box 17199

Jackson, MS 39217

Phone: 601.979.2246
Fax: 601.979.8246