NIGMS-funded Short Course Application Form

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NIGMS-funded Short Course
Application Form
July 7 - 11, 2014
UAB, Birmingham AL
Welcome to the 4th 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 travel 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 a US Institution.
To apply, please perform the following tasks either via our website or sending materials to derry@uab.edu:
1.
Complete this application form. Only fully completed application forms will be considered.
2.
Forward your current curriculum vitae.
3.
(required for Travel Fellowship Award and/or Bursary Award consideration) One page proposal on a research project
including the specific aim of the project (We will offer a novel service to selected participants to assist them either in
their ongoing research projects, or in a newly initiated project which could lead to publication in a refereed journal or a
submission of an investigator initiated grant proposal). Questions? Contact Dr. Hemant Tiwari – htiwari@uab.edu
4.
(required only for Travel Fellowship Award consideration) Letters of recommendation (minimum of two).
Attendance is limited. Please apply prior to Fri 5/30/2014. Accepted applicants will be notified by Mon 6/2/2014 and
applicants should make arrangements for registration fee by June 21st.
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
$2,600 - for-profit organizations
Acceptance includes course tuition, syllabus, and refreshment breaks. Fee will be payable upon acceptance into the course.
Need more information? Contact Derry Crawford at 205.975.9298 or derry@uab.edu.
Name
Degree
Position
Institution
Address
City State Zip
Country
Phone
Fax
Email
Website
Description of disability accommodation(s) you may require.
Travel Award
Yes
Race/Ethnic
(All that apply)
Vegetarian
Bursary Award
No
Sex
Male
Yes
No
Female
American Indian or Alaskan
Native
Black/African American
Hispanic/Latino
Asian or Pacific Islander
White/European
Other (please specify)
Yes
No
Course Website: http://www.soph.uab.edu/ssg/nigmsstatgen/fourth
Refund and Cancellation Policy: Attendee substitutions are allowed, but notification must be made in writing by Friday, June
27, 2014 and sent to derry@uab.edu or by fax at 205.975.2541. After this date no substitutions will be granted. 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 9298
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