Faculty of Medicine Bluma Tischler Postdoctoral Fellowship The Bluma Tischler Postdoctoral Fellowship Award is for MD or PhD graduates in medicine, biochemistry, genetics or associated disciplines carrying out research on the biochemical or genetic aspects of mental retardation or other neurological disorders. AWARD $20,400 for one year. Holders of the award may apply for a second year. ELIGIBILITY Applicants must hold a postdoctoral appointment at the University of British Columbia for the full duration of the fellowship. No citizenship restrictions apply. APPLICATION PROCEDURES A completed application consists of: 1. A completed application form (below) 2. Post-secondary transcripts from all post-secondary institutions attended Copies of transcripts are accepted, but each page must be initialed by the proposed supervisor of the candidate’s postdoctoral research. Initialing of official sealed transcripts is not required. 3. Letters of support from three sponsors One letter should be from the proposed supervisor of the candidate, and the others from individuals familiar with the candidate’s academic and research abilities. Sponsors are asked to comment on the applicant’s research potential and achievements, interpersonal skills, academic abilities, and greatest strengths and weaknesses. Letters should be addressed to the Executive Associate Dean, Research, and submitted in sealed envelopes. Letters may be sent separately but must be received by the application deadline. Submit complete application via mail to: Dr. Howard Feldman Executive Associate Dean, Research c/o Lisa Ritland Faculty of Medicine 317-2194 Health Sciences Mall, Vancouver BC, V6T 1Z3 Please do not use staples or print double sided. DEADLINE TO APPLY: April 10, 2015 at 4:00pm Please direct any questions about this award to Lisa Ritland at med.research@ubc.ca or 604-822-8633. Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Applicant Last Name Applicant First Name Initials (s) of Middle Name(s) Applicant Current Mailing Address Applicant Permanent Mailing Address Applicant Telephone Number(s) Applicant Email Address Start Date of UBC Postdoctoral Appointment (MM/YYYY) Department of UBC Postdoctoral Appointment UBC Supervisor UBC Supervisor Email Date MD or PhD Completed (MM/YYYY) Institution MD or PhD Completed Appointments held Begin with your present appointment and list each appointment held since your first degree (e.g. Postdoctoral Fellow, Research Assistant, etc.) Position Title Department Institution Period Held (MM/YYYY–MM/YYYY) Discipline Institution Date Received (MM/YYYY) Degrees and diplomas received Degree/Diploma 1 Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Scholarships and other awards offered Begin with your most recent award and list only competitive awards based on academic or research excellence and/or leadership or communications abilities. Name of Award Annual Value (CDN$) Location of Tenure 2 Period Held (MM/YYYY–MM/YYYY) Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Publications Begin with your most recent contributions and list each entry on a new line. Do not include any articles that are currently in preparation or those on which you do not appear as an author. Use the following headings in the order indicated: a) Articles published or accepted in refereed journals b) Articles submitted to refereed journals c) Other refereed contributions d) Non-refereed contributions 3 Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Publications (continued) 4 Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Proposed research project Provide a brief summary of the proposed research project, including its relevance to the field of biochemical and/or genetic aspects of mental retardation or neurologic disorders. Limit your summary to 750 words. Title of Proposed Research Project Summary of Proposed Research Project (maximum 750 words) 5 Faculty of Medicine Bluma Tischler Postdoctoral Fellowship APPLICATION FORM 2015 Sponsors Name Title Address Signatures Applicant Signature Date Supervisor Signature Date Department Head Signature Date Attachments: All post-secondary transcripts (copies initialed by supervisor of postdoctoral fellowship accepted) Letters of support from three sponsors (including supervisor of postdoctoral fellowship) in sealed envelopes 6