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2005 fMRIDC Summer Workshop Application

A. Application Requirements

Along with the submission of this application, the following items are required for an application to be considered:

  1. Current Curriculum Vitae.
  2. Two letters of recommendation.
  3. A one-page statement explaining why you wish to attend.
The above items may either be sent to

The fMRI Data Center
6162 Moore Hall
Dartmouth College
Hanover, NH 03755

or emailed directly to summerworkshop@fmridc.org.

B. Identification

First Name:
Middle Name:
Last Name:
Degree:
Job Title/Position:
Employment Address:
Mailing Address
(if different):
Daytime Telephone:
      (Please include country & city code for International Calls)
Fax Number:
      (Please include country & city code for International Calls)
E-mail address:
Please indicate whether you would object to having
your email address be published in our directory: Yes No

C. References:

List two people who will supply letters of recommendation:
  Reference 1
Name
Title
Institution
Address
E-mail
  Reference 2
Name
Title
Institution
Address
E-mail

D. Provided by the Data Center:

  • Housing.
  • Some meals.
  • Course material.
  • Partial Travel Reimbursement depending on budget limitations - amounts to be determined after 3/30/2005.
APPLICATION DEADLINE - MARCH 31st, 2005
Notification of acceptance will occur no later than April 30, 2005.

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