Request Form

(This form may also be printed and submitted with documentation to the Committee Chair´s box)

Please provide the information requested in the following fields. The information will be used by the by the Travel Committee to distribute funds.

When finished, click the "submit" button (or "start over" to clear what you have entered).
 

Please paste or type a copy of your narrative into the text area below. The narrative should explain why study abroad is essential to completion of your program.

In the text area below, please give approximate itemized expenses of your stay abroad. Indicate here the amount by which study abroad exceeds  you normal summer expenses. Provide details of any funding received from other sources (including summer teaching or other work), and the specific amount you would like to receive from Custard-Horton.

Was language acquisition mandated in your letter of offer?
Yes No Not sure

Thank you for providing this information.