Travel Scholarship Application

Applicant Information

Name
Phone	999-999-9999
Email
Address
City
State	Two-letter code, like IL
Zip Code	Five-digit code, like 61820
Organization
Percent of Time Working with Farmers	%
Years in Position
Specialty Area
Have you received a SARE travel scholarship in the past 2 years? Yes No

Conference/Event Information

Estimated Cost of Travel

Lodging	$
Registration Fees	$
Meals	$
Misc.	$
Details
Airfare	$
Mileage (miles)	× $0.50 = $
Total Cost of Participation	$
Total Money Requested from SARE	$

Application Questions

Please rate your current knowledge level on this topic.
- No knowledge
- Beginner — some knowledge but not enough to teach or answer most technical questions.
- Knowledgeable — can provide some technical information on the topic but could know more.
- Expert — confident of your abilities to provide technical advice and teach on this topic.
What do you expect to learn from this conference or event?
How do you plan to use this new information in your work? Check all that are applicable.
- Answer client questions
- Individual Consultation
- Develop new contacts and partners for work
- Incorporate new ideas and information into regular programming
- Develop Special Programming on this topic
- Use in newsletters, newspaper columns, or radio shows
- Other
Any other comments

Applications are due by the 15th of each month

Illinois Small Farms