Report Form CDC Grants
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Final Report Form on Use of IMU/ CDC Support (Individual and Conference Grant Support and VLP Program)

Please copy this data into a word file, fill out and send as a word document to the CDC Administrator in Berlin via email.

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Date of submission of report: (mm/dd/yyyy, e.g. 05/15/2011):

1. CONTACT INFORMATION:

Name:

Home Institution:

Position in Home Institution:

Address

City:

State:

Postal Code:

Country:

Email Address:

2. SUPPORTED ACTIVITY:

a. Individual research travel support

b. Conference support

c. Project support

3. DETAILS:

Country and city of scientific activity:

Dates of scientific activity (mm/dd/yyyy): from: to:

Amount of CDC support (in US$):

Itemized report on use of funds: (e.g. 1300 USD flight cost, 50 USD bus to conference location)

Please note that we will also need receipts of the reimbursed travel costs (scanned or via mail) of the participant(s) as well as their names, positions and home universities. (Please add or delete rows if necessary)

 

Name of supported person

Email Address

Position (e.g. professor)

Home university/ institution

Amount of support

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. SCIENTIFIC REPORT (max 3 pages):

 

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Please note that if you send this report you agree that we may publish this report on the CDC or other IMU related webpages and/ or printed materials. If you do not want to have the report published, please note this in your report document.

We are always very thankful to receive any kind of pictures or further documents (e.g. supported publications, VLP lecturer's course material and suggestions).

Please email this document to: IMU Secretariat Berlin.

 

 

last updated: 2011-10-27