Qualtrics Survey | Qualtrics Experience Management

Full Name

KU ID

KU Email Address

Application Semester

Faculty Reference Name

Faculty Reference Email

Department

Degree Program

Estimated Graduation Semester/Year (Ex. Summer 2023)

Name of Conference or Research Travel

Select the location of your conference

International (Outside of USA)
National (Domestic non-Regional/State/Local) (Further than the Regional Locations)
Regional (Missouri (non-KC), Northern Texas (Dallas/Fort Worth), Oklahoma, Nebraska, Colorado, Iowa, Arkansas)
State (Kansas or Kansas City, Missouri)
Local (Lawrence)

What city is your conference in? (City, State, Country)

Travel Start Date

Travel End Date

Amount Requested from GEA

Purpose of Travel (select all that apply)

To select multiple options in a row, click and drag your mouse or hold down Shift when selecting. To select non-sequential options, hold down Control (on a PC) or Command (on a Mac) when clicking. To deselect an option, hold down Control or Command and click on a selected option.

Select the type of application

Future Conference
Past Conference
Future Research Travel

Please provide the full title of your paper, poster, award, competition, or research travel

If you have received GEA funding previously, how many times and when? (put NA, if not applicable)

Upload proof of conference or travel opportunity (ex. screenshot of conference website)

Upload GEA Budget Form

Upload proof of acceptance