IUBMB-Wood-Whelan Application form – UpdatedApplication – Wood-Whelan Research Fellowship Applicant information Title Mr.Mrs.Ms.Mx.MissDr.Prof.Other Title First Name * Middle Name Last Name * Pronouns (optional) Prefer not to respondShe/herHe/himThey/themPrefer to self-identify as Pronouns (optional) Email * Are you a resident of a Country that is a member of IUBMB * Yes NoThis is a requirement If yes, please provide details Member certificate or letter upload * Drop a file here or click to upload Choose FileMaximum file size: 2MBPlease upload a certificate or confirmation letter of membership in your local Biochemistry and Molecular Biology society. Accepted file types: pdf, jpg, jpeg, gif, png, Max size 2MB. Current position * Institute name * Department name * Room number Full mailing address (include civic number, street, city, country, postal code) * Phone (include country and area code) * Current supervisor Current supervisor Name and Title * Supervisor Email * Full mailing address (include civic number, street, city, country, postal code) * Host informationIs your Host a Resident of a Country that is a Member of IUBMB? * Yes NoThis is a requirement If yes, please provide details Name of receiving institute * Name and Title of Host Supervisor at Receiving Institute * Email of receiving supervisor * Full mailing address (include civic number, street, city, country, postal code) * Project Details Project title * The Nature of the Project and the Type of Experiments to be Carried Out * Up to 1.5 pages Travel justification * Why it is necessary to travel to a particular laboratory to conduct the experiments rather than to perform them in the applicant’s own laboratory or simply to ship the materials Planned Start Date * Planned End Date * Time justification * Why will the project require the particular time period requestedAcknowledgment of Receipt of the Fellowship should be made in any Publication(s) that arise(s) as a result of the visit. * Agree DisagreeBudgetA comprehensive budget should be provided (in US dollars) Airfares * Economy return airfares. Attach an estimate of the travel costs provided by a travel agent. Accomodations * Indicate the accommodation costs for the duration of the stay in the host country for the period of the Fellowship Other expenses * Total This field will automatically update Provide travel details * Provide accomodations details * Indicate the accommodation costs for the duration of the stay in the host country for the period of the Fellowship. Provide details. Provide details of other expenses * State how these Travel and Accommodation Costs will be Covered, if in Excess of the Maximum of USD $5,000 per IUBMB Fellowship. * Indicate ALL Other Sources of Support, Whether Awarded or Applied for. * Supporting documents Curriculum Vitae of Applicant * Drop a file here or click to upload Choose FileMaximum file size: 2MBAccepted file types: pdf, jpg, jpeg, jpe, gif, png, Max size 2MB. Travel Costs Estimate * Drop a file here or click to upload Choose FileMaximum file size: 2MBPlease attach an estimate of the travel costs provided by a travel agent and be based on the costs of the cheapest flight available. Accepted file types: pdf, jpg, jpeg, jpe, gif, png, Max size 2MB. Letter of acceptance * Drop a file here or click to upload Choose FileMaximum file size: 2MBA letter of acceptance from the Head of the receiving institute countersigned by the leader of the group in which the applicant will work, stating that the institute will receive the applicant. A list of papers published by the group leader during the past five years should be provided. This letter should give an indication of the living expenses for the period, if the Wood-Whelan Fellowship is expected to provide funds towards these costs and should also indicate what the receiving institute’s contribution will be towards these costs. Accepted file types: pdf, jpg, jpeg, jpe, gif, png, Max size 2MB. Letter of recommendation * Drop a file here or click to upload Choose FileMaximum file size: 2MBA letter of recommendation from the Head of the department of the applicant’s institution indicating the reasons why the fellowship would be beneficial. This letter should also list all other fellowships previously received by the applicant, especially for travel abroad to attend meetings or to study at another institution. Accepted file types: pdf, jpg, jpeg, jpe, gif, png, Max size 2MB. Signature * signature keyboard Clear Submit Save Draft If you are human, leave this field blank.
Donate now
International Union of Biochemistry and Molecular Biology