Alliance for Global Health and Science 2017 Alliance Summer ...

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May 14, 2017 - Alliance for Global Health and Science. 2017 Alliance Summer Workshop- University of Zimbabwe. Applicant.
Alliance for Global Health and Science 2017 Alliance Summer Workshop- University of Zimbabwe Applicant Name: ___________________________________________________________________________________ Department: ______________________________

Address: _________________________________

Email: ___________________________________

Phone #: __________________________________

Are you a student?

No

Yes

If yes, what is your program of study? Master’s

PhD

Other: ________________

Are you pursuing a research project for your studies?

Yes

No

If yes, who is your advisor: __________________________________________________________________ Are you a faculty member?

Yes

No

If yes, please indicate your current position and department: _____________________________________ Please indicate the highest degree you hold and field of study: _____________________________________ Emergency Contact Name: ___________________________________

Address: _________________________________

Email: ___________________________________

Phone #: __________________________________

Workshop Choice Please rank your top three choices. You may only take one workshop per week. Week 1 July 24- July 28

Week 2 July 31- Aug 04

Bioinformatics

Tissue Culture

Scientific Grant Writing

Protein Purification

Recombineering: Making Gene Knockouts

Please return this cover page and your Curriculum Vitae as a single PDF to Anny Lin, [email protected] by May 14, 2017.

Research Project Description (600 characters):

Personal Interest in Participating (600 characters):