UAB SOM Office of Diversity & Inclusion

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Event or Conference Information

What event or conference are you planning to attend (select all that apply)
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Abstract Submission

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Travel Period: 30 Days prior to conference NO EXCEPTION, Late applications will not be accepted *Reimbursement processing due no later than 30 days after commencement of conference travel
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IF YOU ARE APPLYING FOR THE UAB SOM OFFICE OF DIVERSITY & INCLUSION TRAVEL AWARD

I agree to the following "Statement of Agreement":

1. As a medical student travelling with financial assistance from the University of Alabama at Birmingham (UAB) UAB SOM Office of Diversity and Inclusion (ODI) and Associated Partners within the UAB SOM, I do, by statement of agreement, acknowledge and understand that the UAB SOM is intending to support the educational benefits of this event.

2. The expectation is that I will use these funds to attend the conference meetings, participate in the conference, and contribute to the conference aims. I understand I am a representative of my program, UAB, UAB SOM, and the UAB ODI, and I agree to exemplify the professional nature of the University while on my travels.

3. I also agree that UAB, UAB SOM, and UAB ODI will not be held liable for any damages to persons or property related to this travel.

4. By agreeing to the UAB SOM ODI Travel Award application, I indicate that:

a. I have read and understood the UAB SOM ODI Travel Award Reimbursement Requirements listed on the ODI website.

b. I understand that failure to conform to the policies and guidelines of this document as well as the UAB Financial Affairs Department could result in rejection of my travel reimbursement and/or loss of eligibility for future UASOM travel funding.

c. I understand that providing false information to the UASOM and UAB ODI is a violation of the UAB Honor Code and could result in disciplinary action and/or dismissal from the University.

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