Travel Grant Application Form | Society for Reproduction and Fertility

Only Members of SRF are eligible to apply under this scheme.

Title *

First name *

Surname *

Institution *

Address *

Department *

Town/City *

Postcode/Zipcode

County/State

Country *

Telephone Number

Email Address *

SRF membership category *

Early Career Member

Full Member

Retired Member

If you are an Early Career Member in the first year of your PhD studies, please tick the box below

I am in the first year of my MSc/PhD studies

Please provide the email address of your supervisor to confirm this if required.

Have you previously received a Travel Grant from SRF in the last 2 years. *

Yes

No

If yes please provide details in the next section

Date of event that you attended.

Name of the event that you attended.

This information will be used to

SECTION 1 - TRAVEL GRANT

Name of Conference/Symposium/Workshop *

Location (City) *

Dates *

(Please note that Travel Grant applications must be submitted before the first date of the conference that you wish to attend)

Organisers *

Visa - please indicate if you will be applying for a travel visa to attend this conference/workshop *

Yes

No

Please note that travel grants will only be paid once the Secretariat has received confirmation from you that your visa application has been successful

Details of applicant's participation:

Poster Presentation

Yes

Poster presentation title

Oral Presentation

Yes

Oral presentation title

Invited paper

Yes

Invited paper title

Session Chair

Yes

Session title

Delegate (not presenting)

Yes

Supplementary Information

Details of any other meetings planned with colleagues or other anticipated benefits to your work:

SECTION 2 - EXPENSES

Please give full details (costs in UK Pounds Sterling)

Cost of travel

Flight from (name of town or city)

Flight to (name of town or city)

Flight cost (GBP)

Train from (name of town or city)

Train to (name of town or city)

Train cost (GBP)

Car from

Car to

Car cost (GBP)

Other means of transport from

Other means of transport to

Other cost (GBP)

Cost of subsistence

Bed and Breakfast - Number of nights

Bed and Breakfast - Total cost (GBP)

Lunch(es) - No. of Days

Lunch(es) - total cost (GBP)

Dinner(s) - No. of Days

Dinner(s) - total cost (GBP)

Congress Fee

Cost of Conference/Symposium Registration Fee (in GBP)

Total Costs *

Total amount requested *

SECTION 3: APPLICATIONS FOR GRANTS FROM OTHER SOURCES

(Please enter 'None' for a and or b if you are not being offered support or if you have no other applications pending)

(a) Details of support offered from other sources

(b) Details of other applications pending (include the date when the outcome will be known)

(c) Reasons why support from own University or Institute is not forthcoming *

SECTION 4: CONTACT DETAILS

(Your Head of School/Department/Division may be contacted to verify your information. Please provide their contact details below)

If you are the Head of Department please tick

Yes

(If you are the Head of Department, please provide details of the Administrative Officer below)

Name of Head of Department *

Email Address *

Position *

Please check your entries carefully before pressing submit.
Make sure that you have given the correct details for all the contacts required.
Your application cannot be considered without these details.

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