Travel Stipend Application

4th Symposium on Infectious Diseases in the Immunocompromised Host

APPLICATION DEADLINE: EXTENDED to Monday, February 6th at 11:59 pm PDT/UTC-7

Please use the form below to submit your application for a trainee travel stipend to attend the 4th Symposium on Infectious Diseases in the Immunocompromised Host — You will be notified of your application status in early February.

There are two options for applying for a trainee travel stipend. You may choose either to submit an abstract proposal along with 1 letter of recommendation or you may opt to not submit an abstract and instead provide 3 letters of recommendation.

The following are required with your application:

1)  A statement of interest in seeking the travel stipend/attending the symposium
2)  Signed letter(s) of suppport on institutional letterhead from:
       - at least 1 faculty mentor (if you are submitting an abstract proposal), or
       - 3 total faculty mentors (if you are not submitting an abstract)
3)  Current curriculum vita
4)  Your completed application must be signed, dated and submitted using the submit button at end of this form (see instructions at bottom of page).

An abstract proposal is optional and is not a requirement of the trainee stipend award program.

Questions? For questions regarding abstract submission, please contact: IDAdmin@fredhutch.org

Note: This application is an online form that does not allow for saving and submitting later. You must complete and submit before exiting.

Trainee Application Form

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PART A

Applicant

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Contact Information

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Mentor and Other Current Affiliations

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Demographics

Our training programs are supported in part through funding from the U.S. National Institutes of Health (NIH). The items in this section are useful to us in order to assess and report to the NIH the diversity of applicants and participants in our program. Consideration may be given to individuals with disabilities, those from disadvantaged backgrounds, or those from racial or ethnic groups considered to be underrepresented in health sciences by the NIH. 

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What is your gender identity? [* = required]
What is your ethnicity? [* = required]
What is your race? [* = required]
Are you a person with a disability? [* = required]

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Please review the following list of experiences and then select the statement that is true for you (see below for definitions**): [* = required]

- Have ever been homeless - Spent any portion of childhood in the foster care system - Have/had no parents or legal guardians who completed a bachelor’s degree - Were eligible as a child for the U.S. Federal Free and Reduced Lunch Program for two or more years - Were or currently are eligible for U.S. Federal Pell grants - Received support from the U.S. Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child - Grew up in a rural area of the United States or an area with a shortage of health professionals

Previous Educational Institutions

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PART B

Upload Required Statement of Interest, Curriculum Vita and 1 Letter of Recommendation**

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** All letters of recommendation must be signed and on institutional letterhead.

Please fill out either Part C or Part D below. Then be sure to scroll to the bottom of the page to sign, date and submit your application.

 

PART C

2 Supplemental Letters of Recommendation For Those Not Submitting an Abstract

NOT required if submitting an abstract proposal

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** All letters of recommendation must be signed and on institutional letterhead.

PART D (optional)

Abstract Proposal

An abstract submission is optional. Please complete Part D only if you would like to be considered to give a poster presentation for the Trainee/Emerging Researcher portion of the symposium. We welcome original contributions to the field in the below scientific areas.

All abstracts need to be related to infections in the immunocompromised host.

- Antimicrobial Resistance
- Antimicrobial Stewardship
- COVID-19  
- Cytomegalovirus  
- Fungal Disease
- HHV-6 
- Immunotherapy
- Influenza, Other Viruses & Immunology
- Microbiome
- Respiratory Virus Disease
- Vaccines
- Other topic related to infections in the immunocompromised host

If you choose to submit an abstract, please enter ALL authors' names AND affiliations in the order they will appear on the poster. Include your own name/affiliation along with any co-authors. Text may either be typed in or copy/pasted.

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SELECT CHECKBOX TO AGREE TO THE FOLLOWING STATEMENT: [* = required]

Please enter your abstract text in the spaces below. Text may either be typed in or copy/pasted.

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The abstract word limit is 350. Up to 2 figures/tables may be submitted separately using the upload links below.

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Abstract Subject Area: [* = required]
Do you have any disclosures directly related to the topic (i.e. personal fees for consulting, lectures, any patents) within the past 12 months? [* = required]
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REQUIRED FOR ALL APPLICANTS:

Important: Please sign your application by typing your full name and the date in the space provided.

By entering your name, you are confirming that the materials and information you have provided are accurate and correctly reflect your eligibility for a travel stipend.

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Important — you should receive a confirmation email immediately after submitting your application. If you do not receive a confirmation email, please contact IDadmin@fredhutch.org .

Click SUBMIT button above to submit all application materials. Please press "Submit Application" only once. There will be a delay while your materials are uploaded.

Applications must be submitted by: Monday, February 6th at 11:59 pm PDT/UTC-7

Questions? Email: idadmin@fredhutch.org