COMPANION TRAVEL APPLICATION FORM
NAME:
__________________________________________________________________
TELEPHONE: _____________________
E-MAIL: _______________________________
UNIVERSITY AFFILIATION:
_______________________________________________
DEPARTMENT:
_______________________ SOCIAL SECURITY #: ______________
ACM MEMBERSHIP
NUMBER: _______________________________________________
MAILING ADDRESS:
_________________________________________
_________________________________________
_________________________________________
LIST PAPERS ACCEPTED TO ISCA 2007
1.
TITLE:______________________________________________________________
PAPER
PRESENTER:____________________________________________________
2.
TITLE:______________________________________________________________
PAPER
PRESENTER:____________________________________________________
OTHER SERVICE TO ISCA 2007
(e.g., workshop presentation with
paper title and presenter, committee membership)
___________________________________________________________________________
___________________________________________________________________________
REASON FOR REQUEST, OTHER SOURCES
OF TRAVEL MONEY, AND EXTENT OF NEED
___________________________________________________________________________
___________________________________________________________________________
ESTIMATED TRAVEL EXPENSES:
TRAVEL FROM
____________________________ To San Diego CA
AIR-CARRIER TO BE USED: __________________________
ROUND TRIP COST: __________________________________