USENIX Association Student Grant Application

[Carolyn Carr]

            USENIX Association Student Attendee Grant
			   Application Form

The Association will award a limited number of travel and accommodation
grants to full-time students interested in attending the C++ Conference
in Washington, DC, April 22-25, 1991.

Interested full-time students should return this form
together with a copy of their current student identification to:

		Doug Nielson, Deputy Executive Director
		 	USENIX Association
		  2560 Ninth Street, Suite 215
			Berkeley, CA 94710

Applications must arrive by March 20, 1991.

If you have not yet received information about registration,
please contact the USENIX Conference Office at tel: 714-588-8649.


_______________________________________________________
Name

______________________________________________________
Street Address

_____________________________________________________
City,  State,  Zip Code

___________________________    ______________________
Phone number			e-mail address

____________________________
Academic institution


Expense Request

Please estimate as best you can


Travel:			_________

Accommodation:		_________

Fees:			_________


Total Requested:	$_________


___________________________________
Date / Signature