Travel Awards: 1. Personal Details

TRAVEL AWARDS
Please email completed form to: awards@theiet.org Hand written forms will not be accepted.
CONFIDENTIAL APPLICATION FORM
1. PERSONAL DETAILS
Surname: First name(s): Nationality: Contact Details: Address Line 1: Address Line 2: Address Line 3: Postcode: Country: Telephone: *E-mail: Title: Date of Birth:
*Please provide an email address that you use regularly, as all correspondence will be carried out via email
*Category of IET Membership:
*Membership No:
*Travel Award applicants are required to be IET members at the point of application.
How did you first hear about the IET Travel Awards? IET Website IET Email Bulletin IET Magazine please specify: IET Student Talk University Other Website please specify: Word of Mouth Poster School/College Leaflet National Press please specify:
2. COSTS & FUNDING

Please indicate the estimated cost of the visit: Travel Subsistence Special Equipment Other
Funding requested from other organisations: Organisation Type of award/grant Amount Expected
Funding obtained from other organisations: Organisation Type of award/grant Amount Obtained Yes Yes Yes Yes No No No No
Is your visit dependant upon obtaining an IET Travel Award? Have you enclosed documentary evidence of the travel proposal? Is a visa required for the visit? If a visa is required, have you submitted documentary evidence that this has been sought / obtained? Amount requested from the IET: (maximum 500)
3. EDUCATION
University Full title of Course/Research Programme Date of commencement Date of Completion
Full time
Published papers
Part time
Title of published paper
Authors
Date
Journal / Conference
Sponsor
Poster or Oral? Poster Oral Poster Oral
Poster Oral Poster Oral Poster Oral
4. REASON FOR APPLICATION Complete Section A or B as appropriate

SECTION A: Attendance at Conferences Title of conference Title of paper to be presented Venue Co-authors (if applicable) Duration of Conference From To Poster Oral Country Poster or Oral?
SECTION B: Travel Purpose Purpose of visit Duration of Visit from: To:
Location of Visit
Country
Description of the research or educational programme which you are to undertake:
5. TRAVEL ITINERARY
Please include details of all aspects of your journey: Date & Time Mode of Transport Location Destination Activity
6. OBJECTIVES
Please note; your application is much more like likely to be successful if you give full and well thought out answers to the questions in this section. How will the visit further the objectives of the IET?
How will the visit benefit yourself?
How will the visit benefit your employer?
How will the visit benefit your research?
7. EMPLOYMENT
Details of employment and experience, if any: From To (Month & Year) Employer Job Title Main Responsibilities
8. IF AWARDED A TRAVEL AWARD

Would you object to publicity? Yes No
Would you be willing both to acknowledge the support provided by the IET (at the conference or event you plan to attend) and (if requested) to become an ambassador for the IET? Yes No
9. DECLARATION
Once you submit this application, you will agree that in the event of being awarded a travel award, you will attend the course detailed on this form. You also certify that the statements on this form are correct. Please check the box if you agree RECOMMENDATION
10. REFEREE*
Name: Address Line 1: Address Line 2: Address Line 3: Postcode: Occupation: Telephone: E-mail:
Please forward the following with your completed application form:
When completed, please email this form to: awards@theiet.org
Documentary evidence of the travel intention (i.e. letter from sponsor, or copy of the invitation from the conference organiser, research department, company or academic establishment etc.
Please ask your referee to complete the form on the next page. The reference form should be submitted separately from the application form.
TRAVEL AWARDS
CONFIDENTIAL REPORT FROM REFEREE NAME OF APPLICANT
This form should be completed and emailed to: awards@theiet.org In assessing the application, the Institution will take in to account such factors as: Soundness and worthiness of the applicant Research promise and evidence of ability A genuine need for the award, in so far that assistance is not available from conventional sources
The Institution would therefore welcome observations, which could assist in the evaluation of the applicant.
RECOMMENDATION
Name: Address Line 1: Address Line 2: Address Line 3: Postcode: Occupation:
Telephone: E-mail:

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TRAVEL AWARDS

CONFIDENTIAL APPLICATION FORM

*Category of IET Membership:

2. COSTS & FUNDING

Title of published paper

Poster or Oral? Poster Oral Poster Oral

Poster Oral Poster Oral Poster Oral

4. REASON FOR APPLICATION Complete Section A or B as appropriate

SECTION B: Travel Purpose Purpose of visit Duration of Visit from: To:

Description of the research or educational programme which you are to undertake:

How will the visit benefit yourself?

How will the visit benefit your employer?

How will the visit benefit your research?

8. IF AWARDED A TRAVEL AWARD

Please forward the following with your completed application form:

When completed, please email this form to: awards@theiet.org

Name: Address Line 1: Address Line 2: Address Line 3: Postcode: Occupation:

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