OHIO LIONS EYE RESEARCH FOUNDATION

FELLOWSHIP APPLICATION

(This cover page must be the first page of the Fellowship Application)

Date: ________________

Name of Fellowship Applicant: _______________________________________

Name of Fellowship Sponsor or PI: ___________________________________

PI's Phone: _____-_________ PI's Email: ____________________________

Name and Address of OLERF Approved Institution:_______________________

_______________________________________________________________

________________________________________________________________

Check one: _____ New Application _____ Continuation Application

Directions

Only one fellowship application is allowed per OLERF approved institution.

A Fellowship application includes the following:

1. This cover page.

2. Layperson abstract (In plain English, describe the problem to be addressed, methods, expected results and implications of the research. 3 pages max.)

3. Student’s Curriculum Vitae

4. Progress Report. (If this is a continuation Fellowship, list the complete references for presentations and publications that have resulted from the funded research. Send a copy of each abstract and publication funded in whole or in part by the fellowship).

Applications (#1-3) must be received by July 10, 2006 and progress reports (#4, if applicable) by July 14, 2006. E-mail the application (#1-3) to Leguire@ohiolionseyeresearch.com. Mail one copy of the entire application to:

L. E. Leguire Ph.D., MBA

ED 459

Department of Ophthalmology

Children’s Hospital

Columbus, OH 43205

E-mail deadline (#1-3): July 10, 2006. Hard copy deadline (#1-4): July 14, 2006