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Summer Institute on Aging Research

NIA Summer Institute on Aging Research
Aspen Wye River
Queenstown, MD

Summer Institute
July 12-18, 2008

Hartford Geriatric Nursing Initiative
July 11-12, 2008

Application Deadline:
March 21, 2008

NOTE:
Please ensure that you receive an automated confirmation email stating that your submission was successfully received. If you have submitted your application, but have not received this confirmation, please contact Jamie Gulin at 301.451.8846. Thanks very much for your interest in the Summer Institute on Aging Research.

Please note: Qualified applicants must hold a doctoral degree (Ph.D., M.D., etc.). Only applicants working in the field of aging -- or actively considering this research field  -- will be considered.

Please fill in the information below (* required):

First Name*:
Middle Initial:
Last Name*:
 
Preferred mailing address location *: 
 Home  Work
May we distribute your contact information to speakers and particpants?*:
Yes  No
 
Institutional Name*:
Street Address Line 1*:
Street Address Line 2:
City*:
State*:
Zip/Postal Code*:
  Country:
 (please specify if outside U.S.):
Home Phone:
Work Phone:
Fax Number:
E-Mail Address*:
E-Mail Address (confirm)*:
 
Position*:
 Faculty
 Post-Doctoral Trainee
 Other:
 
Pre-conference Session:
  Please also consider my application for the Hartford Geriatric Nursing Initiative pre-conference session for nurses (July 13-14)  
   
Are you a: U.S. Citizen, Permanent Resident or Non-citizen National?*
 Yes
 No
Degree:*
 Ph.D.
 M.D.
 M.D., Ph.D.
other:

Discipline:*

Research Interests:*


Ethnicity:
Submit Supplemental Materials (Word or PDF format):
1. Curriculum vitae* :
2. One page research
proposal abstract*:
 
3. A typed statement of 150 words or less describing your objectives in attending the Summer Institute (SI) on Aging Research.   In writing the objectives you might consider plans for future research, needs for further training and how you expect the SI to benefit you.*:
Attachment:
 
4. Two letters of recommendation from professional references addressing the applicant's demonstrated ability and commitment to future research in the field:
Letter 1*:
Reference*

Name:

E-Mail:  

Letter 2*:
Reference*

Name:  

E-Mail:

 
 


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