AACN 2018 Annual Meeting Scholarship Application

AACN 2018 Annual Meeting Scholarship Application

Dear Applicant,

Thank you for your interest in attending the 16th Annual Meeting of the American Academy of Clinical Neuropsychology (AACN) June 20-23 in San Diego, CA. This year's meeting will feature another outstanding lineup of adult, pediatric, and forensic workshops, as well as a series of student-focused activities, including the annual Student Series, Training Directors’ Hour, and a variety of other opportunities to meet with experienced neuropsychologists and training faculty.

AACN is proud to offer scholarships open to all AACN Student Affiliates who will be first-author presenters at this year’s poster session. The award money can be used to offset the cost of meeting attendance, including conference and workshop registration, travel, lodging, and meals. At least six of the twelve scholarships will be designated as Diversity Scholarships, and the remaining scholarships will be unrestricted. In order to be considered for the Diversity Scholarship, applicants should be either: a) individuals from underrepresented racial and ethnic groups; b) individuals with disabilities; and/or c) individuals from socially, culturally, economically, or educationally disadvantaged backgrounds that have inhibited their ability to pursue a career in health-related professions.

Please submit your completed scholarship application as a single PDF or Microsoft Word document, along with CV in similar format, to the AACN SAC secretary, Stephanie Towns, PsyD, ABPP, at no later than March 15, 2018. Label each document with your first name and then the document title (e.g. Smith Application, Smith CV). Please feel free to contact Stephanie or me with any questions regarding this opportunity.

Sincerely,

Leslie Guidotti Breting, PhD, ABPP

Chair, AACN Student Affairs Committee

APPLICANT NAME: ______

CITY/STATE OF RESIDENCE: ______

DISTANCE TO CONFERENCE:

☐Local ☐Driving Distance☐<2 Hr Flight ☐>2 Hr. Flight

SCHOLARSHIP TYPE:

☐Unrestricted☐Diversity

CURRENT TRAINING STATUS:

Doctoral Student:☐Yr 1 ☐Yr 2☐Yr 3 ☐Yr 4 ☐Yr 5 or above ☐Intern

Postdoctoral Resident:☐Yr 1☐Yr 2

DOCTORAL EDUCATION

Name of Program: ______

APA/CPA Accredited?☐Yes ☐No

Have you graduated?☐Yes ☐No

If no, when do you expect to graduate? ______

RESIDENCY PROGRAM

Name of Program: ______

Houston Conference Guidelines adherent

formal 2-year postdoctoral fellowship?☐Yes ☐No

Name of Training Director: ______

Is the Training Director ABPP

board certified in clinical neuropsychology?☐Yes ☐No

AACN MEMBERSHIP

Are you currently a student affiliate member of AACN?*☐Yes ☐No

AACN PRESENTATIONS

Have you submitted a poster abstract for presentation

at the 2017 AACN Annual Meeting as a first author?*☐Yes ☐No

If more than 1, how many? ______

Have you submitted a poster abstract for presentation

at the 2017 AACN Annual Meeting as a co-author?☐Yes ☐No

If more than 1, how many? ______

STUDENT INVOLVEMENT IN AACN

Are you actively involved (e.g., leadership/service position, volunteer at annual meeting(s), poster presentations) in AACN?

☐Yes ☐No

If yes, please specify: ______

REFERENCES

Primary Reference: ______

Position: ______

Email address: ______

ABPP board certified in clinical neuropsychology?☐Yes ☐No

Secondary Reference: ______

Position: ______

Email address: ______

ABPP board certified in clinical neuropsychology?☐Yes ☐No

PERSONAL STATEMENT

In 500 words or less, please describe the following:

1)Your professional interests and goals

2)How attending the AACN 15th Annual Meeting will help to enhance your professional development

3)Your active involvement in professional organizations related to neuropsychology

4)The ways in which travel to the AACN 15th Annual Meeting will represent a financial hardship for you

[Please include personal statement here]

CURRICULUM VITAE

[Please include CV with application in a Word or pdf document.]

*Required in order to be eligible