Travel Awards Application Form

Award Selection:

Awards open to current ARLIS/NA members:
(see eligibility requirements at: http://www.arlisna.org/about/awards/awards_index.html):

Conference Attendance Award   Andrew Cahan Photography Award   AskART Conference Attendance Award  

Awards open to eligible applicants:
(see eligibility requirements at: http://www.arlisna.org/about/awards/awards_index.html):

Howard & Beverly Joy Karno Award   Student Award for Conference Attendance Student Diversity Award for Conference Attendance  

Applicant Information:

Name:  
Mailing Address1 : 
Mailing Address2 : 
Phone:   (Work)      (Home)  
Fax:  
Email:  

Institution:  
Title of present position:  
At present position since:  
Status 1:   Full time Part time   Status 2:   Permanent Temporary

ARLIS/NA Conference Attendance History:
First-time attendee
Previous Travel Award recipient
Veteran attendee

Number of years attended:  
Year last attended:  

Projected Expenses:

Description	Amount
Conference Registration	$
Workshop Fees	$
Travel to & From conference city	$
Local Travel Expenses	$
Lodging	$
Meals	$
Subtotal:	$
Departmental/Institutional Support	$
TOTAL Anticipated Need	$

Conference Participation:

Session/Workshop moderator/speaker:   Yes No

Session name:


Conducting ARLIS/NA business as chair/officer of:
Committee   Section   Division   Round Table   Chapter  
Committee/Section/Division/RT/Chapter Name:  

Conference Goals Statement:

1. Describe why you are eligible for selected award. (maximum one page)


2. Describe your specific interests and expectations of the conference in terms of your current projects and professional development goals. (maximum two pages)


3. List your employment history, education, and professional activities.


4. List three professional references (two for student award):