American federation for aging research 55 West 39th Street, 16th Floor, New York, ny 10018 (212) 703-9977



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AMERICAN FEDERATION FOR AGING RESEARCH

55 West 39th Street, 16th Floor, New York, NY 10018 (212) 703-9977
2017 Glenn/AFAR Scholarships for Research in the Biology of Aging

Instruction Sheet
Please carefully read the application guidelines on the AFAR website, www.afar.org/research/funding/glenn-afar-scholarships, before completing this application. If you are uncertain whether your project meets the program criteria and relevance to the biology of aging in particular, please do not hesitate to contact AFAR.

INSTRUCTIONS
Materials to be submitted by the applicant
The application must be submitted by email through scholarship@afar.org, no later than January 17, 2017, at 5:00 p.m., EST. The application should be sent as a single PDF file application, not to exceed 5 MB. Late submissions or submissions sent by regular mail or fax will NOT be accepted. The file should be named as follows: “last name, first name”; for example “Smith, John.pdf”. Late submissions will NOT be accepted for any reason.
UPON SUBMISSION, YOU WILL RECEIVE AN EMAIL FROM AFAR CONFIRMING RECEIPT OF YOUR APPLICATION. IF YOU DO NOT RECEIVE AN EMAIL, PLEASE CONTACT THE AFAR OFFICE RIGHT AWAY.
The application file should be assembled in the following order:


  1. Application pages

    1. Cover page

    2. Part 1 (background and personal statement)

    3. Part 2 (proposed research)

    4. Part 3 (mentor plan)




  1. Mentor’s NIH-style biographical sketch (not to exceed five pages)




  1. Academic transcripts from all institutions attended (may be student copies – ok if printed from website but name of applicant MUST be visible).

The PDF file may not include any additional documents; please submit only the required materials.




  1. Letter of Support. The letter should be written by an undergraduate advisor, faculty member or senior professional (not the mentor) who is well-acquainted with the candidate’s capabilities, activities, and accomplishments. The letter is NOT to be included in the application, but must be submitted directly to AFAR by the letter writer (NOT the applicant), to scholarship@afar.org as a Word or PDF file. Letters submitted via regular mail are also accepted.

Section 4 is NOT to be included in the application.

DO NOT INCLUDE THIS INSTRUCTION SHEET WITH YOUR APPLICATION!



2017 Glenn/AFAR Scholarships for Research in the Biology of Aging

Application
[Cover page: should be the first page of your application]
Title of Proposal (cannot exceed 20 words):

Dates of Proposed Research (the project start date must be between May 1, 2017 and December 31, 2017):





Name, Address, Telephone, and Email Address of Applicant:

autoshape 7Signature

autoshape 8Date of Birth

autoshape 9

Country of Citizenship



Permanent Address, Telephone, and Email, if different from above:

Check the appropriate box:

  • autoshape 4PhD degree anticipated in (Month/ Yr.)




  • autoshape 5MD degree anticipated in (Month/Yr.)




  • autoshape 6MD/PhD degrees anticipated in: (Month/Yr.)

Name, Title, Institution, Complete Mailing Address, Telephone, and Email of Mentor:

autoshape 10

Signature of Mentor



autoshape 11

Date



Does the research plan include use of human subjects? YES  NO
Does the research plan include use of animal subjects?  YES NO
Applicants should note that IRB certification (for human subjects) and/or Animal Use Committee approval (for animal subjects) must be provided to AFAR before a grant award can be made.
Applicants are urged to consult the AFAR website at http://www.afar.org/research/funding/animal-use/ for advice on human and animal usage. The website includes a helpful set of guidelines for optimal use of rodents in aging research projects.

PART 1 BACKGROUND AND PERSONAL STATEMENT
GRADUATE OR PROFESSIONAL SCHOOLS ATTENDED/ATTENDING

Institution Dates Major Degree GPA


UNDERGRADUATE SCHOOLS ATTENDED

Institution Dates Major Degree GPA

HONORS AND AWARDS IN UNDERGRADUATE – GRADUATE SCHOOLS

EXTRACURRICULAR, COMMUNITY, AND AVOCATIONAL ACTIVITIES

COURSES OR OTHER EXPERIENCES IN GERIATRICS, GERONTOLOGY

LIST CURRENT SALARY, STIPEND, SCHOLARSHIP SUPPORT. INDICATE SOURCE, AMOUNT, AND DATES FUNDED.


PUBLICATIONS

NAME OF PERSON WHO WILL SUBMIT A LETTER OF SUPPORT (cannot be the mentor)
Name Title Institution

HOW DID YOU HEAR ABOUT THE PROGRAM?


PERSONAL STATEMENT INCLUDING CAREER GOALS, RELATION OF THIS WORK TO OTHER PROJECTS IN WHICH YOU ARE NOW ENGAGED (IF APPLICABLE) AND HOW THIS SCHOLARSHIP MAY ADVANCE YOUR CAREER IN AGING RESEARCH (Limit 500 words)


PART 2 PROPOSED RESEARCH
TITLE AND SUMMARY OF PROPOSED RESEARCH to be written by student (not to exceed 5 pages, references in addition to the proposal not to exceed 2 pages). Insert page number and applicant’s name at the top of each page, and use Arial font that is not smaller than 11 point with at least 1/2 inch margins on all sides. Any figures must be included in the 5 pages.

Address each of the following (identify each section by the corresponding letter):




    1. A detailed explanation of your research project including background, aims, and hypotheses;

    2. Relevance and significance of this research to the field of aging;

    3. How the research will be conducted, methodologies and timeline;

    4. How the research will be analyzed;

    5. Facilities available; include statement of space committed to your use, and space shared with others.

    6. If the project is part of a larger study, specify the aims that will be achieved in the three- to six-month period.

    7. If this is a resubmission, indicate in one or two paragraphs how this year’s application differs from your previous submission.


PART 3 MENTOR PLAN
To be written by the mentor, describing plans for the proposed research and professional development, and addressing the following:


    1. Plans for coursework

    2. Participation in seminars and other opportunities for in-depth training in aging research

    3. Plans for communication and support during the research period (frequency of meetings with the applicant, etc.)

    4. Plans to encourage and expand the applicant’s career in aging research

    5. Description of the available facilities for the student’s use

    6. Description of the available financial resources (in addition to the scholarship support) to execute the project

    7. Explanation of previous interactions with the applicant

    8. Mentor’s history of training others over the past 5 years – list the trainees’ positions while in the mentor’s lab and the title and institution where they are today



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