Applicant Information - OHSU



-1988552International ACED Summer School:Discovery and Development of Diagnostics for Early Detection of CancerPhD Scholarship ApplicationDue April 15, 2020Applicant InformationFull Name:Last nameFirst nameDate:Application dateLastFirstInstitution:Institution nameProgram:ProgramProgram / Study FieldAddress:Street addressStreet AddressCityState or CountyPostal codeCityState / CountyPostal CodeCountryCountryPhone:Phone numberEmail:EmailWill you require a visa to attend the Discovery and Development of Diagnostics for the Early Detection of Cancer Summer School in Portland, Oregon USA?Yes?No?Note: the scholarship award does not cover the cost of any visa. The student or home institution must fund visa costs.Award covers the cost of the Summer School Registration fee only, not inclusive of travel or hotel accommodations.EducationName of University awarding first degree:Name of UniversityFirst degree subject:Degree subjectDegree received:DegreeDate degree awarded:Date degree awardedName of University awarding Ph.D.:Ph.D. University nameProposed Ph.D. title:Ph.D. dissertation titleExpected completion date:Expected completion datePh.D. Supervisor:Ph.D. supervisor nameEmail:Supervisor emailStatementsExplain your interest in cancer early detection and how participation in the 2020 ACED Summer School will enhance your Ph.D. experience. (300 words max)Statement of support from supervisor / personal tutor. (300 words max)Supervisor signature:Date:Date signedDisclaimer and SignatureI certify that my answers are true and complete to the best of my knowledge. If this application leads to a scholarship award, I confirm that I will attend the ACED Summer School in Portland, Oregon from July 14 – 17, 2020.Applicant signature:Date:Date signedReturn completed forms to watsoner@ohsu.edu by Wednesday April 15, 2020.Late applications will not be considered. ................
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