AMERICAN SCIENTIFIC AFFILIATION ANNUAL MEETING -- 2001
APPLICATION FOR SCHOLARSHIP AID:
UNDERGRADUATE AND GRADUATE STUDENTS
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STUDENTS PLANNING TO PRESENT PAPERS (ORAL OR POSTER FORMAT) MAY APPLY FOR SCHOLARSHIP AID TO PARTICIPATE IN THE ANNUAL MEETING OF THE AMERICAN SCIENTIFIC AFFILIATION AT KANSAS STATE UNIVERSITY: JULY 20 TO 23, 2001. AWARDS UP TO $300 WILL BE MADE.
TO BE CONSIDERED FOR FINANCIAL AID, INDIVIDUALS MUST SUBMIT THE FOLLOWING FORM WITH THEIR ABSTRACT. SCHOLARSHIP RECIPIENTS MUST BE MEMBERS* OF THE ASA AND PLAN TO PARTICIPATE IN THE FULL MEETING.
Your name: _________________________ Subject area of your paper:
Home institution _________________________ ____ Social Science
Mailing Address: _________________________ ____ Engineering and Technology
_________________________ ____ Origins issues
E-mail address: _________________________ ____ Environment
Phone Number _________________________ ____ Biomedical/Biotechnology
____ Cosmology/geology
Your field of study _________________________ ____ Biological Sciences
Degree you are working toward ____ Chemistry/physics
_______ Bachelors ____ Biochemical/molecular
_______ Masters ____ Science and Religion
_______ Doctorate ____ Other (specify)___________
_______ Other (specify) _______________
Title of your paper __________________________________________________________
Preferred format (check one)
______ Oral presentation (abstract and scholarship application due March 1, 2001
______ Poster presentation (abstract and scholarship application due March 1, 2001
To be signed by your Department Chair or major professor: I affirm that the above information is correct and that the individual named above is a full-time student.
Signature: _______________________________
Title: _______________________________
*A Student ASA membership is $20 per year. See http:/www.asa3.org for information about the ASA and for a membership application