Midwestern email address

Graduation Year

Club Affiliation

Name of Conference/Event

Place of Travel (city, state)

Departure date (MM/DD/YY)

Return date (MM/DD/YY)

If you do not receive the scholarship, will you still travel (Y/N)

Have you previously presented research? (please list)

Name and contact info of private investigator and/or lab

Please include an essay of 300 words or less describing your research and why YOU
should be given this scholarship to present your research

Copy of official letter of invitation or acceptance to present by the event sponsors

must be sent to AZCOMSGA@gmail.com