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Awards, Scholarships and Grants FOUNDATION FOR GENETIC TECHNOLOGY
Foundation for Genetic Technology Genome Award
Application Instructions Save this page for future reference!
PURPOSE: To acknowledge and honor outstanding technologists in cytogenetics and molecular genetic technology. This award program contributes to the growth of genetic technology as a profession by recognizing individuals with superior professional success. ELIGIBILITY: DOCUMENTATION:
SELECTION CRITERIA: 1. Quality of abstract.
3. Evidence of outstanding contribution to the profession of cytogenetics or diagnostic molecular genetics. 4. Initiative. AWARD:
NOTIFICATION:
Foundation For Genetic Technology Genome Award Application DUE DATE : February 5, 2007Deadline: Must be Postmarked by February 5, 2007 Mail To : Foundation for Genetic Technology Genome Award P.O. Box 625 Biloxi, MS 39533-0625 SECTION I - Biographical InformationNAME : ______________________________________________________________________________ Last First Middle Initial ADDRESS:_____________________________________________________________________ Street City State Country Zip Code PHONE NUMBER:______________ SOCIAL SECURITY#_____________________________ DATE of BIRTH:___________________ AGT MEMBER#:_______________________________ NAME of LABORATORY:_________________________________________________________
SECTION II On an attached sheet please provide a current CV including: work experience and evidence of outstanding contribution to the profession of cytogenetics or molecular genetics. Please be specific and provide complete names of pertinent employment as well as a letter from your current director.
SECTION III Use an attached sheet to submit a short abstract of particular genetic interest to you or your work.
SECTION IV-Certification Statement I affirm that, to the best of my knowledge, the above statements are correct. I understand that I am responsible for the submission of all required documents within the deadlines. The Foundation for Genetic Technology reserves the right not to process applications found to be late or incomplete. ________________________________________________________________________________ Signature Date
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