Affiliation/Address ________________________________________________________ ________________________________________________________________________ E-mail Address____________________________________________________________ Title of Research Presentation at IHS Quadrennial Meeting:________________________ ________________________________________________________________________ Author(s) _______________________________________________________________ Amount Requested __________ Detailed travel plans _______________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Estimated Travel Costs: Registration ___________ Lodging ___________ Transportation ___________ Meals ___________ Other ___________ Other funds received, applied for, or anticipated _________________________________ ________________________________________________________________________ ________________________________________________________________________ Applicant's Signature ______________________________________________________ If applicant is a student: Faculty Research Advisor's Signature _________________________________________ |
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*Please attach an abstract of the research to be presented, not to exceed 250 words* *Applicant's curriculum vitae and one letter of reference are also required* |
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Contact information: Dr. Paula Levin Mitchell, Secretary, IHS Department of Biology Winthrop University Rock Hill, SC 29733 USA FAX: 1-803-323-3448 mitchellp@winthrop.edu |
Print this page and and submit it with the requested documents to the above contact information. |
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