Application for IUIS VIC PhD/DVM Student Travel Award to attend the Keystone Symposium on "Immunity to Veterinary Pathogens: Informing Vaccine Development " to be held at Keystone Conference Center in Colorado, 19- 25 January, 2015 Submit Application by October 21, 2014 To Elisabetta Razzuoli, RETE NAZIONALE DI IMMUNOLOGIA VETERINARIA, [email protected] 1. Name: 2. Work address: 3. Email: 4. Current position (including start/end date of PhD/DVM training): 5. Confirm that you are submitting an abstract as first and presenting author: Yes/No* Please provide a copy of the abstract: 6. Please provide a statement (no more than 750 words) explaining the value of attending this Symposium for your research and how this bursary will assist your attendance: 7. Please list any peer reviewed publications arising from your current research that are relevant for this application: 8. Amount requested **. Provide information on other sources of support that will enable you to attend this Symposium, including any other travel award applications : 9. Declaration. I hereby confirm that if I am awarded this travel bursary and cannot attend the Symposium I will return the award to the Rete Nazionale di Immunologia Veterinaria. In accepting the award I agree to submitting a report on the Symposium that will be published on the IUIS website within 3 months of the meeting. Signed and dated (applicant):......................................................................... I agree that the above information is correct: Signed and dated (PhD Supervisor or any equivalent legal entity):............................................................... * Delete as required ** Maximum amounts (in US dollars) are: $1000 (Europe).