Application for 2016 AAPS PPB Education Initiative Award
Only one application can be submitted for each student chapter per academic year.
Schools or student chapters awarded a PPB EI Award within the last three years are not eligible to receive an
award this year.
Return this form to Mary Jo Bean via email at BeanM@aaps.org
Name of School:
Topics of interest:
1.
(list up to 3; see appendix)
2.
Contact Information
First Name:
Organization/University:
Address:
M.I.:
City:
3.
Last Name:
State:
Zip Code (plus 4 if available):
-
Country (if outside of the U.S.):
E-mail Address:
@
.
Telephone Number:
Program Information
The objectives of this initiative are 1) to provide support to AAPS Student Chapters, in particular those
schools with limited funding for external speakers, 2) to help promote careers in pharmaceutical sciences
by encouraging attendance of undergraduate (B.S. in the Pharmaceutical Sciences, Biology, and
Chemistry) and Pharm.D. students at these seminars, and 3) to provide an opportunity for graduate
students, postdoctoral fellows, and junior faculty to meet and interact with senior scientists.
Applications will be judged based on the program description, involvement of both undergraduate and
graduate students, postdoctoral fellows and junior faculty, documentation of limited funding to support
such a program, and selection of speakers who are PPB members and whose membership is active in
AAPS. No chapter will be eligible for funding if the chapter has received a PPB Education Initiative
Award within the last three years.
The award will cover only incurred expenses (e.g., coach class airfare, hotel for up to 2 nights, taxi, and
light meals during travel) up to $1000 for Student Chapters in North America or $1500 for International
Chapters. Honorariums and food for group functions will not be covered. The speaker is expected to
spend one full day at the university. At a minimum, the speaker will give a 1 hr seminar and meet with
students (both graduate and undergraduate), postdoctoral fellows and junior faculty for a minimum of 3 to
4 hrs.
Applications are due by Dec 5, 2015 and awards will be announced by Dec 19, 2015. Only AAPS
Student Chapters are eligible for these awards. The student chapter is responsible for contacting the
speaker and arranging the visit once the travelship has been awarded. The seminar and submission of
reimbursement form must be completed by Dec 15, 2016 or the award is forfeited.
Version 2015
Return this form to Mary Jo Bean via email at BeanM@aaps.org
School Demographics
1. How large is the College/University? Estimated Number of students_______________
2. Is there a program in Pharmacy, Pharmaceutical Sciences or Pharmacology? (graduate or
undergraduate?)
Yes
No
a. If yes, how large is the program in Pharmacy, Pharmaceutical Sciences or Pharmacology?
i. Estimated Number of undergraduates
__________
ii. Estimated Number of Pharm D students
__________
iii. Estimated Number of graduate students (PhD/MS) __________
3. Is this an AAPS Student Chapter? (graduate / undergraduate)
Yes
No
4. Potential # of undergraduate attendees?
5. Potential # of graduate student attendees?
6. Potential # of postdoctoral fellow/junior faculty attendees?
7. Potential # of junior faculty interested in meeting with speaker?
Provide a general outline of the itinerary, including seminar times, meetings with students, postdoctoral
fellows and/or junior faculty. The speaker is expected to spend the good portion of an entire workday
visiting the school.
Provide details about the specific topic(s) of interest and why you are applying for support by this
program (500 words maximum).
Provide a list of potential speakers (no more than 3):
DO NOT CONTACT ANY SPEAKER UNTIL THE APPLICATION HAS BEEN FUNDED.
Name
Affiliation
Address
Email
AAPS
PPB
member
member
Yes
Yes
1.
No
No
2.
Yes
No
Yes
No
3.
Yes
No
Yes
No
PPB Topics
 Dermatopharmaceutics
 Discovery Modeling and Simulation
 Drug Candidate Selection
 Excipients
 Inhalation and Nasal Technology
 Lipid-Based Drug Delivery Systems
 Modified Release
 Nanotechnology
 Oral Absorption
 Preformulation
 Targeted Drug Delivery and Prodrug
Version 2015
Return this form to Mary Jo Bean via email at BeanM@aaps.org