| ECCB '06 Travel Fellowship Application Form
Please fill out the form and press "Submit" once.
All fields are required unless indicated otherwise.
To make subsequent changes, send e-mail to eccb06@diesenhaus.com; do not apply again.
General Information
full name
mailing address for sending reimbursement check:
street
city
state/province
zip/postal code
country
e-mail
tel
fax (optional)
affiliation (institute/university)
academic status are you an ISCB member?
Presentation
kind of presentation
presentation title
Budget
geographical location I can attend only if I receive at least USD I can attend without a fellowship, but would appreciate travel support brief budget of needed funding other available funding for attending conference Weizmann Institute postdocs ONLY: What funds are left in your travel account? USD have you attended previous ECCB conferences list years of ECCB, ISMB, RECOMB, and PSB conferences you have attended have you previously received a fellowship from ECCB Academic record Please enter the URL of your CV, if it is online. If it is not online, please e-mail a copy of your CV to eccb06@diesenhaus.com, with the subject line "cv for eccb travel fellowship". The CV should be in Word or PDF format with your name as it appears on this application (e.g., john_smith_cv.doc or jane_doe_cv.pdf). URL of your personal homepage or the homepage of your group or institute if you do not have a personal homepage Miscellaneous gender country of residence country of citizenship
The submission deadline has passed. |