AACR Minority Scholar in Cancer Research Awards Program
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AACR Minority Scholar in Cancer Research Awards Program AACR 100th Annual Meeting 2009 • April 18-22, 2009 • Colorado Convention Center • Denver, CO M Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities R O F The American Association for Cancer Research (AACR), a scientific society of more than 28,000 investigators working in all subfields of basic, clinical, and translational cancer research, is extremely pleased to announce the availability of AACR Minority Scholar in Cancer Research Awards. These N awards are intended to enhance the education and training of minority researchers and to increase the O visibility and recognition of minorities involved in cancer research. I AACR Minority Scholar Awards are supported by funds provided through the NCI Center to Reduce T Cancer Health Disparities, and are available to meritorious minority scientists for participation in the AACR 100th Annual Meeting 2009, April 18-22, 2009 in Denver, CO. The AACR 100th Annual A Meeting 2009 will: C • attract approximately 17,000 scientists and exhibitors from around the world; I L • provide the latest findings in the most rapidly developing areas of basic, clinical, and translational cancer research; and P • feature major presentations from prominent scientists who are making important P advances in the field. A Participation in the AACR Annual Meeting will: L • expose these minority investigators to the wide spectrum of high-quality, cutting-edge cancer research being performed nationally and internationally, and will buttress their A knowledge base in the cancer field; I • contribute to the research, training and networking opportunities for minority C investigators; and I • facilitate the development of relationships between minority scientists and senior F investigators in the field, thereby contributing to the career development and professional success of these scientists as cancer researchers. F O The award consists of financial support for the registration, travel, and subsistence expenses incurred in connection with attendance at the AACR Annual Meeting. Award money will be issued to Scholars to permit a minimum of four days attendance at the Annual Meeting. The deadline for submission of award applications is December 15, 2008. 080906 AACR Minority Scholar in Cancer Research Awards Program Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities Qualifications 5. Curriculum vitae, including a complete bibliography (list of publications). Eligibility Candidates must be full-time graduate students, medical students Format or residents, clinical or postdoctoral fellows, or junior faculty Application materials should be submitted in the order listed in members who are either engaged in cancer research, or who have the Application section. Applications must be typed. Faxed training and the potential to make contributions in this field. This applications are not acceptable. The original (including award program applies only to racial/ethnic minority groups documents that contain original signatures) and additional copies which have been defined by the NCI as being traditionally must be mailed or postmarked by December 15, 2008. underrepresented in cancer and biomedical research; these groups are African American/Black, Alaskan Native, Hispanic/Latino, Native American, and Native Pacific Islander. Only citizens of the Selection United States and Canada or scientists who are permanent Please note that when reviewing applications, the Award Selection residents in those countries may receive one of these awards. Committee will consider the following factors: AACR Membership • candidates who have submitted an abstract Candidates need not be members of the AACR to apply for this award. • first time applicants • total number of awards an applicant has already received Please keep in mind that because of these factors the total number Application of awards given to any one applicant will be restricted. The application deadline is December 15, 2008. Awardees will be selected on the basis of their qualifications, Required Application Materials references from mentors, and an estimation of the potential A complete application consists of SIX copies (i.e., one original professional benefit to the awardees. An advisory committee and five photocopies, collated into sets) of the following materials: consisting of members of AACR-Minorities in Cancer Research (MICR) carefully reviews submitted applications and letters of 1. Official Application Form provided by the AACR. (Provide all reference. Applicants will be chosen from both minority information requested, even where responses are duplicative of institutions and the larger bodies of universities, colleges, and other parts of the application. The Form must be signed by the research institutes. applicant and one mentor in a faculty capacity (i.e. department head, advisor, etc.) at the candidate’s institution. A photocopy of All candidates will receive notification in early February 2009 this form may be used, but original signatures must be provided from the AACR Office of the final selection of awardees by the on the top copy). AACR-MICR Minority Scholar in Cancer Research Awards 2. A statement written by the candidate (no longer than two, Committee. single-spaced pages in length) describing the benefit he/she expects to derive from attending the conference and the reasons for the candidate’s interest in the conference. Award Conditions and Reporting 3. At least two letters of reference from faculty members from • Awardees will receive a waiver of the Annual Meeting the applicant’s institution or an institution that the applicant has registration fee, economy air or rail transportation, and a stipend attended must accompany this application. The letters should be to permit a minimum of four days of attendance at the Annual addressed to the AACR-MICR Minority Scholar in Cancer Meeting (i.e. housing, meals, etc). Research Awards Committee, and should comment on the • In addition to scientific sessions, awardees must attend all special applicant’s academic and personal qualifications for this award. events organized for them. Applicants must also obtain certification from an individual in a faculty position at the applicant’s institution, i.e. departmental • Awardees must submit a written report commenting on the head, advisor, etc. Lastly, this mentor must also sign the scientific sessions that they attended and the AACR Minority Certification section of the Official Application Form. Scholar Award Program. This report must be received by the AACR no later than May 22, 2009. 4. A copy of the abstract submitted for presentation at the AACR 100th Annual Meeting 2009 (if applicable). If an abstract has • According to IRS regulations, the award is subject to been submitted, candidates must indicate the temporary abstract federal income tax. Award recipients will receive additional number (Abstract submission deadline is December 1, 2008). related information. AACR Minority Scholar in Cancer Research Awards Program Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities ________________________________________________ (Applicant’s Name) Page 1 of _____ 1. APPLICANT NAME _______________________________________________________________________________________ Last First MI 2. CITIZENSHIP (please check only one) J U.S. J Canada J Permanent Resident U.S. J Permanent Resident Canada (Note: Only citizens or permanent residents of the U.S. or Canada are eligible for these awards.) 3. POSITION TITLE (please check only one) J Graduate Student J Medical Student J Postdoctoral Fellow J Resident J Clinical Fellow J Assistant Professor J Other (specify): ____________________________________________________________ 4. INSTITUTIONAL ADDRESS Department__________________________________________________________________________________________________ Institution___________________________________________________________________________________________________ Box Mail Stop________________________________________________________________________________________________ Street_______________________________________________________________________________________________________ City_________________________________________ State/Province_______________ Zip Code___________________________ 5. TELEPHONE No.____________________________________ 6. FAX No._______________________________________ area code and number area code and number 7. E-Mail Address______________________________________ 8. Website/URL Address_____________________________ 9. RACE/ETHNICITY J African American/Black J Alaskan Native J Hispanic/Latino J Native American (Supply Tribe and Number)_____________________________ J Native Pacific Islander (Specify)________________________________________ 10. GENDER: J Male J Female 11. BIRTH DATE (Month/Day/Year)_______________________ 12. PLACE OF BIRTH (Country)_________________________________ 13. EDUCATION (Begin with postdoctoral or clinical training and include baccalaureate and undergraduate training.) INSTITUTION AND LOCATION DEGREE CONFERRED YEAR DEGREE CONFERRED FIELD OF STUDY INSTITUTION AND LOCATION DEGREE CONFERRED YEAR DEGREE CONFERRED FIELD OF STUDY INSTITUTION AND LOCATION DEGREE CONFERRED YEAR DEGREE CONFERRED FIELD OF STUDY AACR Minority Scholar in Cancer Research Awards Program Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities ________________________________________________ (Applicant’s Name) Page 2 of _____ 14. What is your current major program area (please check only one)? J Behavioral Research J Chemistry J Molecular Biology & Genetics J Biochemistry & Biophysics J Clinical Investigations J Preclinical Pharmacology & J Biostatistics J Endocrinology/Signal Transduction Experimental Molecular Therapeutics J Carcinogenesis J Epidemiology J Research Administration/Business Development J Cellular Biology & Genetics J Immunology J Virology J Other_________________________________________________________________________________________________ 15. Describe your research experience in the field of cancer research. 16. Describe any laboratory research experience or training. 17. Describe your long-range educational and research training goals, as well as your career objectives in cancer and biomedical research. 18. Within your institution, community, or the cancer field, do you serve or have you served in any voluntary professional capacity? Institution J Yes J No If yes, please explain: ____________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Community J Yes J No If yes, please explain: ____________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Cancer Field J Yes J No If yes, please explain: ____________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 19. Regarding research focused on minority populations: Are you currently engaged? J Yes J No Have you previously been engaged? J Yes J No Do you have plans for future work in this area? J Yes J No Do you have a general interest in this area? J Yes J No AACR Minority Scholar in Cancer Research Awards Program Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities ________________________________________________ (Applicant’s Name) Page 3 of _____ 20. Have you attended any national scientific meetings within the last three years? If so, please list them. Were abstracts on which you are an author Did you present Conference Title and Date Sponsoring Organization accepted for presentation during this conference? this abstract? K Yes K No K Yes K No ___________________________________________________________________________________________________________ K Yes K No K Yes K No ___________________________________________________________________________________________________________ K Yes K No K Yes K No ___________________________________________________________________________________________________________ 21. Are you author or co-author of an abstract(s) submitted for consideration for presentation at the AACR 100th Annual Meeting 2009 in Denver, CO? If yes, a copy of your abstract(s) must accompany this application. Please also provide the temporary abstract number(s) assigned to your abstract(s). Deadline for Abstract Submissions is December 1, 2008. J Yes J No If yes, are you listed as the Presenter of this proffered paper? J Yes J No Please indicate: Abstract Title(s)______________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Author(s)___________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Temporary Abstract Number(s)__________________________________________________________________________________ 22. How did you learn about the availability of the AACR Minority Scholar Award? J AACR Website J AACR Email Blast J AACR Mailing J Colleague J Other______________________ NOMINATIONS: Enclose letters of reference from two faculty members from your institute or an institute that you have attended who can comment on both your academic and personal qualifications for this award. Any special information that the nominator can provide which would distinguish this applicant as a qualified minority investigator is welcome. Sponsor 1 Sponsor 2 Name ______________________________________________ Name ______________________________________________ Title _______________________________________________ Title _______________________________________________ Institution___________________________________________ Institution ___________________________________________ Address _____________________________________________ Address _____________________________________________ ___________________________________________________ ___________________________________________________ Telephone No. _______________________________________ Telephone No.________________________________________ Fax No. _____________________________________________ Fax No. _____________________________________________ Email ______________________________________________ Email_______________________________________________ Website/URL Address __________________________________ Website/URL Address __________________________________ AACR Minority Scholar in Cancer Research Awards Program Supported by a Generous Grant Provided by the NCI Center to Reduce Cancer Health Disparities ________________________________________________ (Applicant’s Name) Page 4 of _____ ASSURANCE AND SIGNATURE OF APPLICANT: If awarded, I agree to accept this award to attend the AACR 100th Annual Meeting 2009 and to participate fully in the program for awardees. This includes but is not restricted to participation in all planned events for awardees as well as the submission of a final report on my attendance at the Meeting. I also certify that I am a citizen or permanent resident of the United States or Canada. If I fail to fulfill any of the requirements of the grant, I acknowledge that I will forfeit this award. Signature ________________________________________________________________ Date ______________________________ INSTITUTIONAL CERTIFICATION (This section must be completed and signed by the mentor. Please print.) I certify that the applicant is a full-time, graduate student, medical student or resident, or clinical or postdoctoral fellow, or junior faculty member in good standing at this institution, and that the applicant’s statements are true and complete to the best of my knowledge. Further, I accept the responsibility for ensuring that the total amount of the award is returned to the AACR, if the awardee does not attend and provide a report on his/her attendance at the meeting as specifically requested above. Mentor J Check this box to indicate that you will attend the AACR 100th Annual Meeting 2009, in Denver, CO. Name _____________________________________________ Title _______________________________________________ Institution___________________________________________________________________________________________________ Street ______________________________________________________________________________________________________ City_________________________________________________ State/Province________________ Zip Code__________________ Telephone No. ______________________________________ Fax No. _____________________________________________ (area code and number) (area code and number) E-Mail Address ______________________________________ Website/URL Address____________________________________ Relationship to applicant (department head, advisor, etc.) _______________________________________________________________ Signature ________________________________________________________________ Date ______________________________ Application Checklist: APPLICATION DEADLINE: Please use the following checklist to ensure all required materials for application are submitted. DECEMBER 15, 2008 J 1. The Official Application Form, signed by the Please send completed application to: applicant and mentor. AACR Minority Scholar Awards Program J 2. Statement by the candidate. American Association for Cancer Research 615 Chestnut Street, 17th Floor J 3. At least two letters of reference from two faculty Philadelphia, PA 19106-4404 members from the applicant’s institute or an institute Telephone: (215) 440-9300 that he/she has attended. FAX: (215) 440-9412 J 4. A copy of the abstract submitted for presentation at E-Mail: firstname.lastname@example.org Website: www.aacr.org/msa/default.aspx the AACR 100th Annual Meeting 2009 (if applicable). If an abstract has been submitted, candidates must indicate the temporary abstract number. J 5. Curriculum vitae, including a complete bibliography (list of publications).