SOT Travel Award Application - 2016 Regulatory and Safety Evaluation Specialty Section (RSESS) Name: ______________________________ Student Status: (undergraduate/graduate/postdoc) ___________________________ Department: __________________________ University: ___________________________ Mailing Address: ______________________________________________ ______________________________________________ Telephone: ___________ Fax: ___________ E-mail:_______________________ Title of presentation to be made at the SOT meeting: ___________________________ ______________________________________________________________________ ______________________________________________________________________ Areas of Research: Select one from below or specify: ___Safety or Hazard Assessment ___ Assay Development __ Models ___ Regulatory and/or Scientific Policy ___ Method Validation ___Other area involving regulations or safety evaluation: _______________________________________________________________ Synopsis and significance of your research to regulatory toxicology or safety evaluation of chemicals, drugs, foods, medical devices, etc. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Along with your abstract of the work you will present at the 2016 SOT Annual Meeting (pasted into the second page of this application), please attach: Letter of Sponsorship from Adviser Submit this application and letter of sponsorship via email to: Michael L. Dourson (mdourson@tera.org): Application Deadline: December 15, 2015 Regulatory and Safety Evaluation Specialty Section 1 Print or Copy/Paste Abstract Here: Regulatory and Safety Evaluation Specialty Section 2