GHFRA/GHEFP Conference Grant Application

First Name

Email

Last Name

Phone Number

School

Arts & Sciences Engineering Medicine Nursing Public Health Education SAIS Carey Business

Department

Degree Pursuing

BS / BA BSN MPH MPP MPH / MBA MSPH MHS / MA MS MS / MPH MSN MSN / MPH PhD DrPH MD MD / MPH MD / PhD ScD Residency

Expected Graduation Date

How did you learn about GHFRA/GHEFP Conference Grant?

Professor Email Notice Website Colleague Other

Title of Conference

Conference Start Date

Conference End Date

Title of Presentation

Type of Presentation

Oral Poster

GHFRA/GHEFP Project Title

GHFRA/GHEFP Faculty Advisor (Last, First)

If awarded this grant, I commit to attending and presenting my GHFRA/GHEFP research. I have obtained all necessary support and consent from my GHFRA/GHEFP advisor. I agree to use the grant for only conference related expenses. I commit to submitting an abstract, appropriate citation and 2 photos from the conference to the Center for Global Health upon my return.

Student Signature

The signature of your GHFRA/GHEFP Faculty Mentor is also required. To complete your application have them confirmation of their support via with Nina Martin | nina.martin@jhu.edu or Anna Kalbarczyk | akalbarc@jhu.edu.