Colgate-Palmolive Postdoctoral Fellowship Award
in In Vitro Toxicology
Please use no less than 10 point font, maintain the given margins, and use no more than the specified pages.
Name
Current Address
City/State/Zip
Phone
E-mail
Institution at which research will be performed
Department
Address
City/State/Zip
Postdoctoral
Name
Program Director
FAX
Signature
Date
The above signature indicates that the applicant has been accepted into your program or will be accepted if an award is made.
Institutional officer responsible for sponsored research programs at which the postdoctoral training will occur
Title
Name
Signature
Date
Doctoral Institution
If degree is
completed
If degree is in
progress
Degree Awarded
Doctoral Advisor
Date Awarded
Degree
Anticipated date of dissertation defense
Your complete application will include:
1. a. This form,
b. budget sheet (form provided),
c. description of research to be performed (as pages 3, 4, and 5; this description must not exceed three pages), including
specific aims of the research and a description of their relevance to the development of methods involving the reduction,
replacement, or refinement of the use of animals,
d. preliminary data in support of the application may be included as an appendix, and
e. brief section addressing the career goals of the applicant.
2. Curriculum vitae (include undergraduate, graduate, and doctoral degree information; graduate appointments; academic
awards; professional experience; bibliography; professional memberships).
3. Reprints of up to three representative publications.
4. Request that three letters of recommendation be sent by e-mail to sothq@toxicology.org using “Col-Pal Fellowship” and
your last name in the subject line. The letters should address all requirements mentioned in the award description. One
letter is to be from the doctoral advisor, noting anticipated date of dissertation defense or certifying completion of the
degree. Another letter is to be from the proposed postdoctoral advisor.
Documents #1-3 above will be uploaded via the Awards site at www.toxicology.org by October 9th of the year preceding the
year in which the fellowship is awarded. Send a signed copy of this form (page 1 only) to Colgate-Palmolive Postdoctoral
Award, c/o Awards Committee, Society of Toxicology, 1821 Michael Faraday Drive, Suite 300, Reston, VA 20190. This must
arrive at SOT within one week (7 days) of the award application.
I have read the stipulations, terms and conditions for the Colgate-Palmolive Fellowship and hereby submit my application to SOT Headquarters.
Signature
Date
1
Budget Sheet
Colgate-Palmolive Postdoctoral Fellowship Award in In Vitro Toxicology
Please provide all information in no more than one page in 10 point font.
Applicant
Title of Position
Budget period (month/year)
Salary
From
From Grantee Institution
To
From Fellowship Award
Salary
Fringe
TOTAL
Other Sources of Funding for Candidate
Expendable Supplies (list individual items that cost over $100 each)
$
$
$
TOTAL
$
Permanent Equipment (over $500)
Item
Justification
Cost
$
$
TOTAL
$
TOTAL
$
TOTAL
$
Travel (include destination and dates)
$
$
Other expenses (list individual items)
$
$
Total direct costs
Indirect costs (not to exceed 8% of total direct costs
$
$
TOTAL AMOUNT REQUESTED (up to $44,000)
$
Provide an abstract containing a brief description of the project in terms understandable to readers without
specialized knowledge in the area of research (maximum length = 200 words).
Add Research Description (no more than 3 pages).
2