Taha Travel Award Nomination Form Your Full Name*Your Preferred Pronouns* She/Her He/Him They/Them Prefer not to specify Your Email* Your Institutional Affiliation*Institutions do not need to be academic to be your primary affiliation. If you are currently not affiliated with any institution, please let us know you are an independent scholar.Is nominee a current ASA member?*Only ASA members are eligible to be nominated for this award. If the nominee is not a current ASA member, they must become a member as soon as possible after submitting this nomination. Yes, nominee is a current ASA member. No, nominee is not a current ASA member, but they will register as a member as soon as possible. Full Name of Nominee*Preferred Pronouns of Nominee* She/Her He/Him They/Them Prefer not to specify Email of Nominee* Location nominee is traveling from (country and city)*Location nominee is traveling to (country and city)*Approximate Dates of Travel*Please list N/A if unknown and explain in the additional comments section below. Title of Annual Meeting Submission of NomineeInstitutional Affiliation of Nominee*Please list the academic institutional affiliation of the nominee. Is nominee a current student?* Yes, nominee is a current student. No, nominee is not a current student. Is nominee considered an "International Student" studying in the United States? Yes, nominee is an international student studying at a US institution. No, nominee is not an international student. No, nominee lives and study outside the US. Degree, Year, and Field of Study*What is the degree, year, and field of study of the nominee? e.g. Masters, 2nd year, African StudiesIs nominee an African student or a student of African descent?* Yes, the nominee is an African student or student of African descent. No, the nominee is not an African student or student of African descent. Estimation of Funds*Please share with us how much funding nominee is hoping to receive from this grant to support nominee’s travel and/or accommodations at the ASA Annual Meeting. Grants will not cover all requested fees this year but we are working towards providing increased support. Will the nominee be available to receive the award in person at the ASA Annual Meeting in the year of the award?This will not affect the nominee’s eligibility to receive the award! Yes, the nominee will be available to receive the award at the ASA Annual Meeting. No, the nominee will not be available to receive the award at the ASA Annual Meeting. I am unsure if the nominee will be available to receive the award at the ASA Annual Meeting. If the award is not granted until after the nominee's planned dates of travel, would they still wish to be considered for the award?Please note that the award recipients may not be selected until after the nominee’s planned dates of travel. If this is the case, the nominee would still be eligible for the award. Please indicate whether they would still travel and wish to be considered for the award if this is the case. This will not affect the nominees consideration for the award unless their travel dates have already passed at the time of review and you have selected “No”. Yes, the nominee would still plan to travel and would still wish to be considered for the award. No, the nominee would not plan to travel and would not still wish to be considered for the award. I am unsure if the nominee would still plan to travel and would still wish to be considered for the award. Letter of RecommendationPlease include the name of the student the letter of recommendation is for in your file name. Max. file size: 128 MB.Additional CommentsCAPTCHA Δ
