AMERICAN PHYSIOLOGICAL SOCIETY
GILES F. FILLEY MEMORIAL AWARDS
FOR EXCELLENCE IN RESPIRATORY PHYSIOLOGY AND MEDICINE
Application Form
Name__________________________________________
Date_________________________________
APS Membership ID #
(REQUIRED)
Address_____________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Telephone__________________ Fax___________________
E-Mail_____________________________
INCLUDE THE FOLLOWING WITH THIS APPLICATION FORM:
DESCRIPTION OF CURRENT AND FUTURE RESEARCH PROGRAM (not to
exceed 3 pages)
JUSTIFICATION FOR HOW AND WHY THE APPLICANT MEETS THE INTENT
OF THE AWARD
COPY OF ABSTRACT SUBMITTED FOR THE EXPERIMENTAL BIOLOGY
MEETING
CURRICULUM VITAE
LISTING OF CURRENT RESEARCH SUPPORT
LETTERS OF SUPPORT FROM DEPARTMENT CHAIR OR SCIENTIFIC MENTOR.
OTHER LETTERS (not to exceed 2) FROM PROFESSIONAL INDIVIDUALS
KNOWLEDGEABLE WITH THE APPLICANT'S WORK.
APPLICATION DEADLINE: NOVEMBER 1.
Submit an Original and Six Copies of All Application Materials
to:
Giles F. Filley Memorial Award
c/o Dr. Martin Frank
American Physiological Society
9650 Rockville Pike
Bethesda, MD 20814-3991
Phone: 301-634-7118
Fax: 301-634-7242
E-mail: [email protected]
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