G:\WAO\Councils and Committees\Research\Research Fellowship Application Forms\revised forms\REVISED WAOshort-term fellowship_2006_general_1_17_06.doc
WAOShort-Term Research Fellowship 2007 Applications
The World Allergy Organization (WAO) offers three Short-TermResearch Fellowships, to commence in 2007, to support junior allergists to visit a center of their choice to learn a research technique. The envisaged duration of each attachment is 2-3 weeks. WAO will contribute up to $2,500 USD, to include travel and accommodations, for each Short-Term Fellowship.
Eligibility
Priority will be given to junior clinicians within five years of award of the most recent professional degree,who are specialising in allergy and who are affiliated to an academic department or clinical institute. Applicants must be current members of a WAO member society.
Fellowship terms
- The visit must be arranged toan allergy department outside of the country of residence of the applicant.
- The institute to be visited may be nominated by the applicant.
- Duration of the attachment: Up to 3 weeks, including travel time.
- WAO will contribute up to $2,500 USD, to include travel and accommodations, for each Short-Term Fellowship. $2,000 will be payable immediately after the Fellowship upon submission of travel and accommodation receipts, and $500 will be payable upon receipt of the final report on the fellowship. WAO will be pleased, if requested, to arrange travel through WAO’s localtravel agency and to pay the invoice directly.
- The Short-Term Fellowship will be applied to a project which meets WAO’s research Priorities:
- Genetic factors involved in the development of allergic disease and response to treatment
- Allergen characterization and standardization
- Clinical and basic studies in allergy and asthma
Materials for application
The following documents must be submitted:
- Application form
- Curriculum vitae
- List of publications
- Description of the research technique to be learned, and the research project to which this technique will be applied (not more than 4, A4 pages with a minimum font size of 12, including references). The description should have the following sections: Summary of research; Purpose of proposed research; Background of proposed research; Plan of investigation, including methods; Relationship to WAO Research Priorities; References; 100-word description of the project for lay readers
- Recommendation from the chair of the home department
- Acceptance from the head of the host institution
- Copy of a document showing date of birth
Application procedures
Application forms may be requested by e-mail from WAO Secretariat:
Applications (original plus 5 copies) should be sent to:
WAO Secretariat
555 East Wells Street, Suite 1100
Milwaukee, WI53202USA
Fax: 1 414 276 3349
It is strongly recommended that the application also be sent by e-mail to
Evaluation and selection
Applications will be evaluated by a reviewing body consisting of the Chairand members of the WAO Research Counciland will be approved by the WAO Executive Committee. Selection will be based on the quality and originality of the project and the applicant’s ability as a clinician and scientist as revealed by his/her CV, publications and the letter of recommendation.
Timing
Applications must be received by WAO head office not later thanMay 31, 2007.
The evaluation process will be completed by June 30,2007.
Applicants may expect an official reply by July 15, 2007.
Payment of grants
WAO will make a bank transfer to cover the costs of travel and accommodations upon receipt of supporting invoices/documents.
Final report
Grant recipients are expected to send a final report to the WAO Secretariat office no later than six months after termination of the fellowship.
Publication
Any publication based on the research work done with the support of the WAO fellowship must acknowledge the support of the work by a WAO fellowship and ten reprints must be sent to the WAO Secretariat.
WAO Short-Term Research Fellowship 2007
Application Form
Applicant:
Name:
Date of birth:
Citizenship:
Institution:
Address:
Tel:
Fax:
E-mail:
Head of department:
□I am qualified to practice as a medical doctor in ______(insert country here)
□I have a working knowledge of English
□I have a working knowledge of the language of the proposed host country
□I am currently registered in a training program in clinical medicine at the above institution
My training specialization is:
□Allergy
□Otorhinolaryngology
□Respiratory/Thoracic Medicine
□Pediatrics
□Dermatology
□General Medicine
□Other (please specify) ______
I have completed a training program in clinical medicine at:
I have experience of, and competency in:
□word processing
□spreadsheets
□database management
□information technology
Short description of experience in basic or clinical allergy research
Proposed Hosting Institution:
Name of Head of Department:
Institution:
Address:
Country*:______
Tel:
Fax:
E-mail:
*The applicant is responsible to verify that they are eligible to enter the country of choice in order to take up the short-term fellowship. WAO cannot assist with visa or work permit applications.
Proposed Project
Title of the project:
Duration of the project:
Expected start date of the project:
Summary of research; No more than 4, A4 pages to include:
- Purpose of proposed research;
- Background of proposed research;
- Plan of investigation, including methods;
- Relationship to WAO Research Priorities;
- References;
- 100-word description of the project for lay readers
- Describe the research techniques to be studied and how they will be applied to the research.
Key words:
□I receive no financial support for this project from any other party, or
I receive financial support for this project from amounting to $ USD
Should I be awarded a short-term Research Fellowship, I will send a final report not later than six months after termination of the Research Fellowship to the WAO Secretariat. I will acknowledge WAO support in any publication based on the research work supported by the Fellowship.
I will immediately inform WAO if my period at the hosting institution has to be interrupted or terminated early for any reason.
DateSignature
WAO Short-Term Fellowship 2007
Recommendation by Current Department
Head of Department:
Institution:
Address:
Tel:
Fax:
E-mail:
I recommend:
Name of Applicant: ______
for a WAO Short-Term Fellowship to learn the following research technique: ______
At Hosting Department: ______
I confirm that this technique is not available within this department and is necessary to the development of our research program. The applicant will be given leave of absence for the duration of the short-term fellowship.
DateSignature
WAO Short-Term Fellowship 2007
Acceptance by Host Department
Head of Department:
Placement Supervisor: ______
Institution:
Address:
Tel:
Fax:
E-mail: ______
Name of Applicant:
has been accepted for a short-term placement in my/our department to learn:
Duration of the short-term placement: ______
Expected date of commencement: ______
I confirm that WAO will not be required to pay any institutional fees or overhead charges in respect to this placement.
DateSignature: Head of Department
DateSignature: Head of Institute (or authorised representative)
WAO Short-Term Fellowship Report 2007
Name:Project Title:
Organization:
Date of Fellowship:
Date report due:
Please complete the following assessment form and return by e-mail (to address below) before the due date.
- Please describe in scientific terms the progress made against the original work outlined in your research proposal (maximum 500 words).
- Please describe in lay terms the progress made (maximum 500 words) and highlight any major advances.
- Please describe the way the WAO Short-Term Fellowship has benefited your research.
- Please list any publications or presentations of the research supported through the WAO Short-term Fellowship.
Please return the completed form by e-mail to:
Karen Henley:
Please describe in scientific terms the progress made against the original