Overview of Request for Funding in Support of Travel for Presenting Your Data at a National, Regional, or Local Meeting as First Author. This form must be completed a minimum of 6 weeks prior to the conference. Please attest that you are the presenting first author for your AOSC, MD/MPH, MD/MA or MD/MS project and that you have not received prior funding from FSM Student Research for travel/conference attendance. Travel to a conference must be authorized in advance by Matt Feinstein, M.D or Liza Rivnay. After completing this form, the Program Manager of Student Research, Liza Rivnay, (liza.rivnay@northwestern.edu) will notify you of the status of this request via email. Once notified, the purchasing process will begin. We urge you not to make any conference related purchases prior to getting a confirmation from Liza. When submitting your request, please include the following information below: