TECHNOLOGIST TRAVEL SUPPORT
Application Form for Travel Support for Technologists Attending SEMS 2010

Each year the SEMS Council considers applications for travel awards to support meeting attendance by Technologists. Awards are made on a competitive basis from limited funds designated by the society for this purpose. Submitting this application does not guarantee that an award will be made.

A. Information
Name
Job Title
Company or Institution
Mailing Address
City, State, Zip	AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Phone
E-mail
How long have you been a SEMS member? (in years)
Name of immediate supervisor
Supervisor's Phone
Supervisor e-mail
B. Anticipated Cost to Attend SEMS 2010 and Budget Request
Budget Item Amount Covered by Individual/Lab/Supervisor Amount Requested from SEMS Hotel       Registration (available only to those presenting) Automobile travel (calculate $0.55/mile) Air Travel (awards for air fare will receive second priority, may not be sufficient to cover entire fare, and are subject to final confirmation of cost) Total
Please use the space provided to briefly comment (150 max) on how participation at the meeting would benefit you and enhance your present position.

APPLICATIONS MUST BE RECEIVED BY APRIL 1, 2010.