NIGMS-funded Short Course Application Form July 8 - 12, 2013 UAB, Birmingham AL Welcome to the 3rd 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 dcrawfor@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 refereed journal or 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 5/24/2013. Accepted applicants will be notified by Mon 6/3/2013 and applicants should make arrangements for registration fee by June 22nd. 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 dcrawfor@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 Sex No Male Bursary Award Female American Indian or Alaskan Native Black/African American Hispanic/Latino Yes No Asian or Pacific Islander White/European Other (please specify) Yes No Course Website: http://www.soph.uab.edu/ssg/nigmsstatgen/third Refund and Cancellation Policy: Attendee substitutions are allowed, but notification must be made in writing by Friday, June 28, 2013 and sent to dcrawfor@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