NIGMS-funded Short Course Application Form The University of Alabama at Birmingham July 11 - 15, 2016 Welcome to the UAB’s Sixth and Last Annual Short Course on Statistical Genetics and Genomics application site. The course is jointly sponsored by the National Institute of General Medical Sciences (NIGMS) and the Section on Statistical Genetics at UAB. There are limited fellowships available for Graduate Students, Post-doctoral Fellows, and early Investigators who are US Citizens/Permanent Residents or who are currently studying and/or working at an US Institution/NIH funded investigators. To apply, please send following documents to statgenetics@uab.edu or wskipwit@uab.edu: 1. Complete this application form, Only fully completed application forms will be considered 2. Forward your current curriculum vitae 3. Letters of recommendation 4. Using a one-page proposal, describe why learning about Statistical Genomics and its methodology would help your current research and/or influence your research career plans. Questions, contact Dr. Hemant Tiwari htiwari@uab.edu 5. For Fellowship, please read the details by clicking on the “Fellowship” tab Attendance is limited. Please apply prior to Tuesday, 05/31/2016. Accepted applicants will be notified by Tuesday, 6/7/2016. Applicants should arrange to pay the registration fee by Friday, June 24. Women, members of underrepresented minority groups, and individuals with disabilities are strongly encouraged to apply. Upon Acceptance, fee: $600 - academic, government, and non-profit organizations $2,500 - for-profit organizations Acceptance includes course tuition, syllabus, and refreshment breaks. Fee will be payable upon acceptance into the course. Personal Checks or Money Orders should be payable to University of Alabama at Birmingham. Cash will not be accepted. Need more information, contact Wanda C Skipwith at 205.975.9193 or wskipwit@uab.edu. Name Degrees Position Institution Address City State Zip Country Phone Fax Email Website Description of disability accommodation(s) you may require. Fellowship Sex Race/Ethnic (All that apply) Vegetarian Yes No Male Female American Indian or Alaskan Native Black/African American Hispanic/Latino Yes Asian or Pacific Islander White/European Other (please specify) No Course Website: http://www.soph.uab.edu/ssg/nigmsstatgen/sixth Refund and Cancellation Policy: An attendee substitution is allowed, but the notification must be made in writing by Friday, June 24, 2016 and emailed to wskipwit@uab.edu or it can be fax to 205.975.2541. Substitutions will not be granted after June 24. UAB reserves the right to cancel this conference, in which case a full refund of your registration fee will be provided. We are unable to refund any travel costs (flight, hotel, etc.) in the case of UABs cancellation. Recording and Photography Clause: UAB reserves exclusive rights to record (audio and video) and/or photograph all conference proceedings for use in marketing materials, presentations and course content sales . The University of Alabama at Birmingham RPHB 414, 1720 2nd Avenue South Birmingham AL 35294-0022 +01 205 975 9193