2024-2025 Cooke Conference and Travel Stipend Outcomes Report

Please complete this report within two weeks of completing your conference or travel.

First Name

Last Name

Birthdate

Email Address

Phone Number

Travel Details

Name of Conference

Dates of Travel

Arrival Date

Departure Date

Travel Destination

Country

City

Region

Tell us about your experience at the conference or during your travel

What new experiences, knowledge, or insight did you gain as a result of this event?

What did you learn and/or accomplish by networking with others? With whom did you network?

Would you recommend this conference or travel experience to other Cooke Scholars?

Yes

No

Why or why not?

How has this event influenced your next steps in your career development?

Your Expenses

Did you use the full amount you were awarded for your conference and travel expenses?

Yes

No

Please upload a copy of your signed expense report

Please upload one document with all itemized receipts in the following order:

Transportation
Lodging
Meals
Conference fees
Please include your conference registration confirmation email along with your receipts even if you are not requesting reimbursement for these fees. We need documentation that you registered for the conference.
Other

If you are having trouble uploading your paperwork, you can email it to scholars@jkcf.org or mail it to:
Jack Kent Cooke Foundation
Attn: Anna Dolga
44325 Woodridge Pkwy
Lansdowne, VA 20176

Scholar Signature

Electronic Signature

Date