Resident/Fellow Travel Request Form First Name*Last Name*UFID*Email* Conference Name*Travel Dates*Expected BudgetRegistration FeeHotelFlightOther (Include the expense type and approximate amount. Note: Food expenses are not covered.)If the conference offers travel assistance/scholarships, did you apply?*No, assistance is not availableYes, I applied, but funding was deniedYes, I applied and was awarded:Amount awarded and items coveredNote: If external travel assistance/scholarships are available, you must apply in order to qualify for internal funding. Please upload a copy of your Poster/Presentation Acceptance Notification*Please upload a copy of your Conference Agenda** I have obtained permission from my Program Director to attend the conference * I have completed all pending administrative items including, but not limited to my New Innovations Checklist, duty hours, procedure logging or otherwise.