2015 Global Senior Scholar Exchange Program
Scholar Application
Please send the completed Scholar Application to bettye@toxicology.org by June 15,
2014.
SCHOLAR APPLICANT
Name (First, Middle Initial, Last):
Position title at institution (such as Professor of Biology, Department Chair, Lecturer, etc.):
Institution
Department
Address
Address 1
City
State/Province
Mail code
Country
Phone
Email address
DEPARTMENT OVERVIEW
Department Chair name
Number of faculty and disciplines represented
Current number of students in Master’s program
Current number of students in PhD program
Current number of students in other toxicology-related programs
Number of students recruited per year
Current Department Toxicology Curriculum
Identify courses relating to toxicology that are taught.
Overview of Research Program (250-500 words)
List specific areas of research within the department with particular focus on the
potential areas for collaboration with potential host institutions.
STATUS OF CURRENT TOXICOLOGY PROGRAM
Identify the main strengths and gaps/perceived needs of your department’s toxicology
program. (250-500 words)
1
What are specific ways in which the SOT Global Senior Scholar Exchange Program
could help strengthen your toxicology program and how would you evaluate the
anticipated impacts? (250-500 words)
Please list your previous international experience, if any (including but not limited to
the following).
International meetings attended
International research exchanges
Training experience outside your country
BROADENING THE REACH AND IMPACT OF TOXICOLOGY GLOBALLY IS ONE OF SOT’S
STRATEGIC GOALS.
Please identify any previous or current regional outreach activities in toxicology or
related fields in which you have been engaged, involvement with local or national
organizations, and other activities demonstrating your ability to influence toxicology in
your region. If this application is successful, are there other initiatives that could be
further capitalized upon to increase impacts? (250-500 words)
Please attach
1. Current curriculum vitae (CV) or resume of the applicant
2. Letter of support from the departmental chair, which describes how the award
will benefit the recipient, the institution, and the region.
2