100%
Questions marked with a * are required Exit Survey
 
Contact Information
* First Name : 
* Last Name : 
* Email Address : 
2nd Email Address (backup) : 
 
 
 
* Institution/Affiliation
   
 
 
* Position/Status
   
 
 
*
Is your current institution an HBCU?
 
Yes
 
No
 
 
 
* Have you submitted an abstract to IAFFE (via ConfTool) for this conference? If yes, please enter title of abstract below.
 
Yes
 
No
 
 
Abstract title.
   
 
 
 
*
Have you been involved in IAFFE activities?  If yes, please explain below.
 
Yes
 
No
 
 
IAFFE activities.
   
 
 
 
* Highest degree completed?
 
Bachelor's
 
Master's
 
Doctorate
 
Other
 
 
 
* What year did you receive your highest degree? (yyyy)
   
 
 
*  Highest degree currently in process (or completed).
 
Bachelor's
 
Master's
 
Doctorate
 
Other
 
 
Not Applicable
 
 
 
* What is the total of your estimated expenses to attend the conference, including the conference registration fee and the conference dinner ($45 USD), if you are planning to attend?
$    USD
 
 
* What is the MINIMUM amount of funding that you are requesting to enable your attendance at the conference?  (Requests may be up to $2,000 USD.)
$     USD
 
 
* What is your PREFERRED amount of funding support to enable your attendance at the conference? (No more than $2,000 USD.)
$    USD
 
 
*
If you qualify for institutional/employer funding, please enter the amount below. (If none, enter -0-.)
$    USD
 
 
* If this grant doesn't cover all of your expenses, how will you fund the balance of your travel expenses?
   
 
 
 
* What country issued your passport?
 
 
If you have a second passport, what country issued it?
 
 
* Where do you currently live?
 
 
 
Please briefly state why it is important for you to attend this conference and note anything else that you would like the committee to consider.