ROBOCUP 2005 TRAVEL SUPPORT FORM

Fill all the fields below and send the filled form to the Organizing Committee
Chair of your league, together with the rest of qualification materials.

NOTE: if the Travel Support Form is not included as part of the qualification
material, this will be understood as no financial support required.
The submission of this form does not ensure the allocation of travel support
to the team.


Team Name: ____________________________________________________
Affiliation: ______________________________________________________
_______________________________________________________________
Team Leader: ___________________________________________________
Team Leader e-mail:______________________________________________

Number of Faculty/Staff: ____
Number of Students: ___

Previous participations in RoboCup events and results obtained (specify year,
event, classification in League and/or Symposium award):




Do you have paper(s) submitted to the RoboCup 2005 Symposium? YES/NO
If YES, please list their title(s) and author(s):



Detail any sponsorships you have for participating in RoboCup2005 (either
institutional grants or company support):


-------------------------------------------------------------------------------
Travel Costs

How much will you spend for travel tickets (roughly) ?: ________________(Japanese Yen)
How much will you spend for accommodation (roughly) ?: ______________(Japanese Yen)
How much will you spend to ship the robots/equipments to Japan (roughly) ?:
_______________________ (Japanese Yen)

How much support does your team request? ____________________ (Japanese Yen)
Justification:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________


Add any other information concerning your team/research group that you
consider relevant:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
-------------------------------------------------------------------------------