2 Week Multi-Modality Short Course : Registration Form

NO MORE APPLICATIONS ARE BEING ACCEPTED FOR THE 2008 PROGRAM

Name:
Affiliation:
Address:
City:
State:
Country:
Zip:
Email:
Phone:
Fax:

Program Date

The 2008 program will run from May 12-23, 2008

Application Deadline is March 1, 2008 and applicants will be notified of acceptance no later than March 15, 2008

ESTIMATED COSTS

The primary costs for participants are for transportation to the program site (Charlestown, Massachusetts), accommodation and incidentals, including most food. There will be some funds available to help if needed for a small number of participants.

There is a tuition charge of $300. This may be reduced or waived waived in case of harship. DO NOT send tuition until notified of acceptance.

Recommended Accommodation is the Constitution Inn, where a block of rooms has been reserved. The course administrator, Stacey Ladieu, will help coordinate room sharing for interested participants after selection. The cost for a room at the Constitution Inn is $99/night. Accommodations at other local hotels is also available, but at higher rates. More information will be provided upon your acceptance into the program.

Biosketch

In the box below, please describe your professional background, what you hope to gain from the program, what special qualities you bring to the program, and how confident you are that you will be able to attend if chosen. "Professional Background" includes your current professional status (graduate student, post-doctoral fellow, assistant professor, etc), the primary type of work in which you have engaged (research, clinical applications, industrial, etc); your level of experience with functional brain imaging (include specific modalities); and the particular content areas in which you are most experienced and/or interested (memory, attention, Alzheimer's Disease, Schizophrenia, child development, etc).

In addition, please include a more informal description of what you hope to gain from the program and what special qualities you would bring to it.

Finally, because we expect there to be more applications than available spaces, it is important for us to know how confident you are that you will be able to attend if accepted. We understand that there are always uncertainties, but we would like to avoid last-minute cancellations out of consideration for the other applicants, if possible.

Hopefully, these biosketches will enable us to select a collection of participants who will contribute to the quality of the program through their interactions and questions with the faculty and each other.