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Travel Grant

CHED application form for travel grants

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Attachment A

Application Form for Travel Grants

1. Name of the applicant (Dr./Mr./Miss/Mrs.)

Please paste a
recent and selfattested
passport size
photograph

2. Status
3. Spouse Name (if married)
4. Nationality
5. Sex
6. Date of Birth
7. Passport No. :
8. Mailing Address (with Telephone No., Fax No./e-mail, if any)
(i) Official
(ii) Residential
9. Academic/Professional Qualifications/ Curriculum Vitae (attach supporting documents)
10. Field of specialization of research work.
11. Details of the Govt. and other sponsorship/assistance/funding availed of and international
conference/seminar/meeting/workshop etc. attended in the last three years (title of the paper
presented, name of the conference, dates, venue, how funding was arranged, etc.)
1. Details of the Conference/Seminar/ /Meeting/ Symposium/ Workshop etc. where the paper has been
accepted by organizers for presentation
a)

Name of the Conference…………………………………………………

b)

Venue of conference……………………………………………………

c)

Date(s) of conference ………………………………………………….

d)

Broad theme(s) of conference…………………………………………

e) Name and address of the organizing/convening Institution (including Telephone numbers,
e-mail address and web-site address, if
available)…………………………………………………………………..
f) Registration fee …………………………………………………………..

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13. Details of the paper accepted for presentation (photocopy of the letter of acceptance of the paper by
the organizers for presentation should be enclosed)
a) Title
b) Subject area
c) Tentative/Expected date of presentation
14. Proposed date of departure from the Philippines for attending the event and expected date of return.
15. The benefits expected to be derived by virtue of attending the event.
16. Breakdown of Travel Assistance (In case the applicant is expecting or has obtained some financial
assistance from source(s) other than CHED)

Amount
Particulars

A. Amount Needed

B. Support from other
sources

Support from CHED
(A -B)

1. Airfare economy class
(to and from) by
shortest air route
between Philippines
and country when
paper is to be
presented. Not to
exceed $1,500.00
2. Per diem ($100) for
duration of conference
plus 1 day
3. Registration fee (in
case waiver has not
been sought) Not to
exceed $300.00
2.

4. Other expenditure

I hereby declare that all the particulars given in this application are correct. I have not hidden any such
fact/information available with me as must be necessarily brought to the notice of CHED). I will satisfy all the
terms and conditions prescribed by CHED. I also agree to be penalized by CHED as deemed fit by it for the
terms and conditions not satisfied by me.
Place:
Date:

Signature of the applicant

Note: The application must contain clear, correct, complete information, with no erasure(s), and with complete
attached documents.
 
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