Society of Toxicology
Award Nomination for 2016 Syngenta Fellowship Award
in Human Health Applications of New Technologies
Privileged Communication
Reference Letter Form — Research Director
The Fellowship is available to a either a third year (or later) graduate student or a postdoctoral trainee. The funding
($15,000) is to support mode-of-action research aimed at characterizing dose-dependent effects of xenobiotics on
mammalian systems in such a way that the causal sequence of key events underlying toxicity is elucidated. The one
year, non-renewable Fellowship is administered by the awardee's department. The Fellowship may commence at any
time between April 1 and September 1, 2016.
The Research Director may nominate not more than two applicants from his/her laboratory in any year.
The Research Director will send the electronic file containing the Reference Letter Form and Letter of
Recommendation directly to sothq@toxicology.org. Name the file “[Applicant last name]_Syngenta_[Advisor last
name]” as a Word or PDF document using “Syngenta Fellowship” in the subject line.
This e-mail nomination must be received no later than October 9, 2015.
Applicant Name
Please provide your best estimate of the month and year of the nominee’s thesis defense
Name of Research
Director
Title
Dept/Institution
Address
City/State/Zip/Country
Telephone
Fax
E-mail
1. Rate the applicant on the items listed below as compared to degree of accomplishment you usually encounter in
students at this level.
1–outstanding, 2–above average, 3–average, 4–below average, 5–poor, and X–insufficient knowledge to rate
Originality
Accuracy
Research ability
Scientific background
Ability to exchange ideas
Ability to organize scientific data
Familiarity with research literature
Proficiency in laboratory work
Perseverance in pursuing goals
2. Add a letter describing the qualifications and traits that you consider of special significance in judging the applicant's
aptitude for a career in toxicology, emphasizing ability in research. Include discussion of weaknesses.