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Application for STaRS Coordinator Scholarship to support conference attendance1,2
Academic Professional
SECTION A PERSONAL DETAILS
Staff ID Number Contact Number
Name (incl title)
Email Address
Years of continuous employment at WSU
Full Time/Part Time:
CURRENT POSITION DETAILS
Position Title Level
Name of School or Unit Campus
Name of Supervisor
Name of Dean/Director/Executive Director
1. CONFERENCE
What is the title of the conference?
Have you submitted a paper for presentation at the conference? Yes No
OR Have you submitted a poster for presentation at the conference? Yes No
Has your Paper/Poster been accepted for presentation? Yes No
If yes, please attach a copy of the abstract and evidence that the paper has been accepted.
Please provide a web link address for the conference site:
When/where will the conference be held?
Date(s):
City: Country:
1 Eligibility: To be eligible to receive the scholarship funding requires acceptance of a paper or poster for presentation at the conference and is available only to STaRS Coordinators, with approval for conference attendance from their Dean or nominee. In competitive situations papers will be given higher priority than poster presentations.
2 Value of the Scholarship: Up to $1,500.Page 1 of 2
SECTION B COSTS
Please provide full details of costs, including conference registration fee, travel and accommodation costs (if applicable) and incidental costs.
Amount $Conference Registration Fee
Course / Activity Fee
Accommodation
Airfares
Meals / Incidentals
Other (Please specify)
Total:If the scholarship does not meet the full costs of the proposed activity, please state how will the balance be paid:
NOTE: If your application is successful, you are asked to share your experience with the STaRS Coordinators group.
Please submit your application by email attachment to:
David Roach – [email protected]
NOTE: This application will be acknowledged by email within 48 hours. If you do not receive acknowledgement, please phone David Roach Ext 3406
NT POSITION DETAILS
SUPPORT BY DEAN / DIRECTOR
I support this application for the STaRS Coordinators Scholarship
Name:
Position:
Signature:
Date:
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