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2011 Basil O'Connor Starter Scholar Research Award Program - Nomination Form
Before beginning, please review the detailed instructions by clicking the Help button in the navigation bar on the left.
To view the Request for Proposals for the Basil O'Connor Starter Scholar Research Award, click here.
PLEASE NOTE THAT ALL OF THE INFORMATION REQUESTED MUST BE FILLED OUT AND SUBMITTED AT ONE TIME. THEREFORE, PLEASE HAVE ALL THE NECESSARY INFORMATION READY BEFORE BEGINNING.
FURTHERMORE, ONCE THE NOMINATION HAS BEEN SUBMITTED, IT CANNOT BE EDITED.
All fields marked with an asterisk (*) are required and must be filled
out in order to submit the nomination. Upon completion, please click the
submit button at the end of the page.
Along with the abstract and the CV, which must be submitted by file upload,
a nomination letter must also be sent. This letter must be sent to
March of Dimes by e-mail, postal service, or FAX. For more details about
the nomination letter, please see the page-specific help.
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* TITLE OF THE PROPOSED RESEARCH PROJECT
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Enter the title of the proposed research project
in the field below with initial capitals (e.g., The Dynamics
and Genetics of Asymmetric Cell Division). The project title
may not exceed 250 characters, including spaces.
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NOMINATOR INFORMATION
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*Degree(s)
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*Academic Rank/Title
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*Department Line 1
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Department Line 2
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*Institution
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Institution 2
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*Address Line 1
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Address Line 2
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Address Line 3
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*City
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State/Province
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Other
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*Postal Code
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*Country
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Other
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*Telephone Number
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(For U.S. and Canadian numbers, please format the
telephone number as 999-999-9999.)
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*FAX Number
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(For U.S. and Canadian numbers, please format the
FAX number as 999-999-9999.)
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*E-mail Address
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CANDIDATE INFORMATION
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*Degree(s)
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*Academic Rank/Title
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*Department Line 1
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Department Line 2
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*Institution
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Institution 2
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*Address Line 1
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Address Line 2
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Address Line 3
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*City
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State/Province
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Other
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*Postal Code
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*Country
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Other
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*Telephone Number
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(For U.S. and Canadian numbers, please format the
telephone number as 999-999-9999.)
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*FAX Number
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(For U.S. and Canadian numbers, please format the
FAX number as 999-999-9999.)
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*E-mail Address
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*CANDIDATE'S CURRICULUM VITAE UPLOAD
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The curriculum vitae (in NIH format) must be in PDF format. The CV may not exceed two pages in length.
Click here to view a sample CV.
To upload the CV, click the Browse button to
locate the file. Select the file, and click the
Open button. Then, click the Upload button to submit
the file.
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*CANDIDATE'S ABSTRACT UPLOAD
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Please format the abstract according to the following specifications:
- No more than one page in length
- 12-point Times New Roman font
- Single-spaced
- One-inch/2.54 centimeter margins
- No headers, footers, or page numbers
The abstract must be in PDF format.
To upload the abstract, please click the Browse
button to locate the file. Select the file and
click the Open button. Then, click the Upload button
to submit the file.
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To complete this nomination, please send a nomination letter, due by
March 15, 2010,
to the March of Dimes by post, facsimile or e-mail. If submitted by e-mail, it must include
the file containing the Letter of Nomination as an attachment and be sent to
BOCNominations@marchofdimes.com.
To send the nomination letter through the postal service, the nominator must sign the back
seal of the envelope. Send the nomination letter to:
Senior Vice President for Research and Global Programs
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
To FAX the nomination, address the coversheet to Senior Vice President for Research and
Global Programs and FAX to: (914) 997-4560.
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