Travel Awards for Tribal Colleges and Universities

Intent to Apply

Please complete the following information to inform us of your interest in applying for a Travel Award to the 2008 Astrobiology Science Conference. Once this information is submitted, a representative will contact you by phone to discuss your interest and what will be required of you to complete the application process.

Applicant and Institution Information

Title Dr. Mr. Mrs. Ms.
First Name
Last Name
Name of College/University
Department
Position
  Full-time Part-time
Length of time with Institution (please indicate months/years/semesters/etc.)
Mailing Address 1
Mailing Address 2
City State ZIP+4 -
Phone 1 (preferred) ( ) - x
Phone 2 (optional) ( ) - x
Cell Phone ( ) -
Fax ( ) - x
Email 1 (preferred)
Email 2 (optional)

This opportunity is open to United States citizens or permanent residents only.

I affirm that I am a United States citizen: Yes No
I affirm that I am a permanent resident: Yes No

We are having spamming problems with our online applications. Please enter your college or university name exactly as you entered it above (it is recommended that you copy what you typed above and paste it here):

After you press the Continue button below, one of two things will happen:

  1. If you see your name at the top of the next page, followed by some questions, your Intent to Apply form has been recorded. Please fill out the questions and submit them to continue the process.
  2. If you see a screen indicating "Thank you, your information has been saved," your information has actually NOT been saved! Please begin the Intent to Apply form again, ensuring you enter your college or university name exactly the same at the top and bottom of the form.

Depending on your email server, you should receive 2 confirmation emails within a couple of minutes of finishing this Intent to Apply process. If you do not receive the 2 emails, check your spam or bulk email folder with a subject similar to "NAI-MIRS Intent to Apply." If you do not receive an email, you should re-submit your application, ensuring you type your information accurately.