New Application NIH/CBB Fellowship Renewal (please select one) *=required field
.
*Name: *UI Identification #:
*Telephone: (home) (xxx-xxx-xxxx)* (work) (xxx-xxx-xxxx)
*Birth Date: (xx/xx/xxxx) *Birth Place:
*Nationality: *Visa Status: *Visa Expiration Date: (xx/xx/xxxx)
Are you a member of a group that is economically or historically underrepresented in higher education?
Your responce is voluntary, and will be held in strict confidence by members of the Coordinating Committee of the Predoctoral Traning Program in Biotechnology.
Do you have a disability?
College: Department:
Date Joined: (xx/xx/xxxx) Expected Date for Completion of Ph.D.: (xx/xx/xxxx)
Ph.D. Comps Taken? Yes No GPA w/o research:
Ph.D. Mentor:
Current year of program:
Past funding/support (list all):
Please forward a current copy (not official) of your University of Iowa Transcript to Mitch Rotman, Center for Biocatalysis and Bioprocessing, C100 MTF, Oakdale Research Park or email PDF copy to mitchell-rotman@uiowa.edu.
*Institution: *Year: *Undergraduate GPA:
*Verbal: *Quantitative: *Analytical: *Advanced:
Institution: Dates:
Nature of Experience:
Additional Degrees Earned: GPA:
Biocatalysis Courses Taken:
*Responsible Conduct of Research Taken: Yes No
*Select one: Place and Date Taken Place and Date Arranged Place and Date to be Arranged
The industrial internship must be arranged or taken by the end of the first year of fellowship support or the fellowship may not be renewed.
This should summarize research already accomplished and plans for the future. List publications, abstracts, etc. (limit this to approximately 700 words).
A brief (no more than four, double-spaced pages) summary of progress.
Please ask for letters of recommendation from three referees who can comment on training and potential for conducting research in the field of Biotechnology/Biocatalysis/Bioprocessing. These should be sent directly by the referee to Mitch Rotman, Center for Biocatalysis and Bioprocessing, C100 MTF, Oakdale Research Park, Coralville, IA 52241 or email mitchell-rotman@uiowa.edu for inclusion in the applicant's file.
Reference 1 (name, address, telephone):
Reference 2 (name, address, telephone):
Reference 3 (name, address, telephone):
Students seeking to renew fellowships do not need three letters of recommendation. A letter of recommendation from your research advisor concisely summarizing the progress the student has made in the past year is required. Forward to Mitch Rotman, Center for Biocatalysis and Bioprocessing, C100 MTF, Oakdale Research Park, Coralville, IA 52241 or email mitchell-rotman@uiowa.edu.
Questions
Please call the Center for Biocatalysis and Bioprocessing (5-4903) or the Coordinating Committee Member from your department listed below:
Charles Brenner, Biochemistry, 5-7934 Tonya Peeples, Chemical and Biochemical Engineering, 5-2251 Mani Subramanian, Chemical and Biochemical Engineering, 5-4900 Eric Nuxoll, Chemical and Biochemical Engineering, 3-2377 Amnon Kohen, Chemistry, 5-0234 Dan Quinn, Chemistry, 5-1335 Tim Mattes, Civil and Environmental Engineering, 5-5065 Robert Kerns, Medical and Natural Products Chemistry, 5-8800 Alexander Horswill, Microbiology, 5-7783
Applications are due at the Center for Biocatalysis and Bioprocessing, C100 MTF, Oakdale Research Park by June 1, 2011
To Whom It May Concern:
I hereby give permission to The University of Iowa committee screening applications for fellowships in biocatalysis to examine and reproduce materials in my confidential files for the purpose of evaluating my application for either an NIH Training Grant, or a Center for Biocatalysis and Bioprocessing Fellowship.
*Name: *Date:
*Email: