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Symposium Winner Documentation
Please complete this form completely in to begin the process of processing your monetary award
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Full Name
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Your answer
Email Address
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Your answer
What was the name of your paper/poster/video?
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Your answer
Names of the others authors on the winning team:
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Your answer
Street Address:
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Your answer
Apartment or Unit Number (if applicable)
Your answer
City, State, and Zip Code:
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Your answer
This question is required so COSGC knows what forms to use - I am a:
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U.S. Citizen
International Student
Read and check-off the following important information to indicate you understand:
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Next week you will receive a W9 via DocuSign. You will need to complete and submit the form in order for COSGC to submit the request for payment.
A check and your official winning certificate will be sent to the address you provide on this form.
It is expected that checks and certificates will be mailed in early June or July. Be sure the address you provide is where you can get a check in the summer.
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Please provide any additional information, instructions, or questions.
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