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Macmillan Learning Travel Grant Application

1. First Name: *This question is required.

2. Last Name: *This question is required.

3. Institution: *This question is required.

4. Department: *This question is required.

5. eMail Address: *This question is required. This question requires a valid email address.

6. Preferred Phone Number: *This question is required.

7. Macmillan Technology you plan to reference in your presentation:

FlipIt
LaunchPad / LaunchPad Solo
LearningCurve
Sapling Learning
Writer's Help
WriterKey
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

8. Conference Name and URL where you plan to present: *This question is required.

9. Has your presentation already been accepted at this conference?

Please enter an 'other' value for this selection.

10. Conference Date(s): *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

11. Conference Location *This question is required.

12. Presentation Title *This question is required.

13. Presentation Abstract of 1000 words or less: *This question is required.

14. Total expected expenditure for the whole conference: *This question is required.

15. Amount requested for this Travel Grant from Macmillan. *This question is required.

16. I understand that I need to disclose this travel grant when I give my presentation using this language, “In the interest of full disclosure, I want to note that Macmillan Learning awarded me a grant toward my travel expenses for this conference.”

17. I understand that, should I receive this grant, I will need to complete and return an ethics form to Macmillan. We will provide you with the form if your travel grant proposal is accepted.