Rocky Mini-Grant - Individual (Conference Support)

Rockefeller Center Mini-Grant Post Conference Form
This form must be completed before receiving approved Rocky mini-grant funding. You must have attended the conference before you complete this form.

Please complete only ONE application per person.

Be ready to provide the following:
- A summary in 400-600 words of what you learned and why you think it was a valuable experience;
- Your best 3-5 pictures in jpg format, be ready to write captions as well;
- Copies of your original receipts saved as a pdf.
Final requirements must be completed within 30 days of your conference. If your conference takes place after June 1st, all final requirements must be received by June 30th.
Please provide the following information:
Full Name*

First NameLast Name
Class year*
Full Dartmouth E-mail*
No alias'. ex. first.m.last.17@dartmouth.edu
Dartmouth ID*
ex. F00000A
HB*
ex. HB6082
Legal Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What was the date you left campus to attend the conference?*
Make copies of your original receipts, save them as a pdf (PDF's ONLY PLEASE!!) and upload them here. Make sure the receipts are clearly marked to explain the expenses.*

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Please give a summary in 400-600 words of what you learned and why you think it was a valuable experience. **Please be sure to spell check. This will be published as a Rockefeller Center blog post and will list you as the author.*
In the mini-grant application, you were asked how you plan to share what you have learned with others on campus. Please explain how and when you shared what you learned with others on campus.*
You were required to take pictures of your project during the implementation. Please choose the best 3-5 photos and upload them as jpegs here.
Photo 1*

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Caption for photo 1*
Photo 2*

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Caption for photo 2*
Photo 3*

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Caption for photo 3*
Photo 4

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Caption for photo 4
Photo 5

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Caption for photo 5
By checking YES to this box, I understand that my name, bio, conference information, and photos will be used in Rockefeller Center outreach and marketing. This may include, but is not limited to: web site, blog, facebook, flickr, posters/flyers, brochures, youtube, newsletters, twitter, and annual report.*

YesI'd like to speak with Rocky staff about this
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Rockefeller Center Mini-Grant Post Conference Form

Please provide the following information: