Submission Date :
Wednesday, February 24, 2021
CIIS ID :
First Name :
Last Name :
Email Address :
Contact & Mailing Address
Street Address 1 :
Street Address 2 :
Contact Phone Number :
Your Academic Information
Academic Program :
Number of years at CIIS :
Please list all the Student Union funding you have received over the last 2 years:
If these funds are for a team effort, please list the other members of the team and their ID numbers on the back of this form.
Please complete the following sections and attach to the application form: Part 1: Please answer each of the following questions. (Please submit approx 250 Word Per Question)
Please Submit your abstract / Purpose of Attending the conference :
How is your conference participation applicable to your course of study? :
What do you plan to accomplish through your conference participation? :
What activities and/or other involvement at CIIS and/or other affiliated organizations support your involvement in the proposed conference? :
How do you plan to share your experience and/or build partnerships via the conference with the CIIS community upon your return? :
Purpose of Award
Title of Conference, Dates, location, other details :
What is your role at the Conference :
Student Budget Template downloadable Form =>
Please upload in a single consolidated file of your supporting documents and Conference Budget.
Please upload the document.
What you agreement to
Please read and check the following boxes :
Signature here :
A copy of your responses will be emailed to the address you provided.
1453 Mission St, San Francisco, CA 94103