Application for an EMS Student Travel Award

Deadline for receipt of Applications: May 28, 2004!

The Environmental Mutagen Society offers competitive travel awards to graduate students who are EMS members, to attend the EMS Annual Meeting and present a paper or poster. This form, including a copy of the Abstract to be presented at the meeting, and a letter of recommendation from the student's research advisor, should be submitted by May 28, 2004. The advisor should cite the student's accomplishments, potential contributions to the field of genetic toxicology in the basic or applied areas, and the benefit to be derived from the student's attendance at the meeting. Reimbursement of a portion of travel costs will be awarded at the meeting. Notification of awards will be made in August. [Please note that as a condition of receiving the EMS Student Travel Award, winners will be asked to work either the lights or the projector at one of the symposia or lectures during the EMS Annual Meeting.]

Last Name*	First*	Middle
School/Dept*
Address*
Address
City*	State/Province*	Zip/PC*
Daytime Phone Number*	Fax	E-mail*
Degree Expected*	Date*	Advisor*
Citizen of*
Lowest cost round-trip airfare from your home city to Pittsburgh, Pennsylvania*
I have received an EMS student achievment award previously* Yes No Year(s)
Thesis Title*
Abstract Title*
*Copy/paste your Abstract into the box below**
*Copy/paste a Supporting Letter from your advisor into the box below**
I am an EMS member* Yes No Membership applied for (Copy of application pasted below.)

Please note that information marked in *color above is required before the computer will accept your submission. Also note that the spaces above for your abstract, letter of support, and, if needed, EMS membership application copy are actually infinite in size even though only the upper left corners are revealed here. If you are unable to submit any of the necessary documents using the boxes above, enter "submitted separately" in these spaces, and send this information by U.S. Mail (or other means) to:John A. Heddle, Ph.D., York University, Biology 4700 Keele Street Toronto, ON M3J IP3 CANADA. All applications will be acknowledged upon receipt. If your submission is not acknowledged within seven days of your sending it, contact jheddle@yorku.ca. Refer any questions about this award application to: jheddle@yorku.ca. Refer any technical questions about this form to The EMS Webmaster.If you cannot use the Web form above to submit your application directly, print out, complete, and mail this form and attachments to:

John A. Heddle, Ph.D.
York University, Biology
4700 Keele Street
Toronto, ON M3J IP3 CANADA
Phone: (416) 736-2100
FAX: (416) 736-5698
Email: jheddle@yorku.ca.