The University of Basel travel fund for early career researchers

Applications with a total amount < CHF 150 cannot be submitted.
There is no legal entitlement to a contribution from the mentioned funding instruments.

Applicant
Form of address
Mrs Mr Mx
Academic title
Nationality
CH D F other :
Last name
First name
Date of birth (dd.mm.yyyy)

Address for correspondence
Street, No.
Zip code
City
Country
CH D F
E-mail address
Private phone no.
Office phone no.
Position
Faculty
Department / Institute
Subject area

Qualifications / degrees
 Year University Grade
Master (Licenciate)
Doctorate
Other
Number of important publications

Event for which a contribution is requested
Event title (maximum 200 characters)
Place of the event
Country    if other:
Event date: from (dd.mm.yyyy)
Event date: to (dd.mm.yyyy)
Title of the presentation/poster (maximum 200 characters)

Details of your trip
Place of departure
Destination
Primary means of transport
Flight Start
(Airport code)		 Destination
(Airport code)		 Date (Start)
(dd.mm.yyyy)		 Flight number Flight class
1
2
3
4
5
6
7
8
9
10

Final statement
Meals, entrance fees museums, etc. in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Cost of hotel, hostel, Airbnb, motel, etc. + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Cost of public transport (train, tram, metro or bus) + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Cost of travel (own) passenger car, Uber or taxi + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Flight tickets + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Visa and travel insurance + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Registration fees meetings, conferences, etc. + in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Subsidy for conference by Dept./SNF/other - in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Total expenses = in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)

Number of children
Gross annual salary in CHF (Swiss Francs, no Centimes, do not use any symbol to separate thousands, e.g., 1234)
Number of nights at the congress venue

Payment address
Account No. Bank or Post
Bank name
City
IBAN

Incomplete forms cannot be submitted.