2023 AHRS Mentorship Grant Award – SUBMISSION DEADLINE: November 30, 11:30pm CST

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Fields marked with an * are required.

APPLICANT/MENTEE INFORMATION

First Name *

Last Name *

Credentials *

Institution *

Address-line 1 *

Address-line 2

City *

State/Province *

Zip / Postal Code *

Country *

Phone *

Fax

Email *

Is the mentee a member of the American Hair Research Society? *

Category *

For example, Dermatology Resident, Medical Student, Dermatopathology Fellow, Clinical Research Fellow, Veterinary Medicine Student, etc.

PAYMENT DETAILS

Please identify the person or institution's name, with mailing address, to whom the check should be issued. On the face of the check, we print the "Payable To" name and the address. This address is where the check will be mailed.

Payable To *

Mailing Address-line 1 *

Mailing Address-line 2

City *

State/Province *

Zip / Postal Code *

Country *

MENTOR INFORMATION

First Name *

Last Name *

Credentials *

Institution *

Address-line 1 *

Address-line 2

City *

State/Province *

Zip / Postal Code *

Country *

Phone *

Fax

Email *

Is the mentor a member of the American Hair Research Society? *

It is required that both the Applicant and Mentor be members of the American Hair Research Society in order to be eligible to apply for the Mentorship Award. An AHRS membership application can be found at http://www.americanhairresearchsociety.org

MENTORSHIP INFORMATION

Mentorship Focus/Title *

Location *

Mentorship Beginning Date (MM/DD/YYYY): *

Ending Date (MM/DD/YYYY): *

BUDGET REQUEST

You may upload a budget or using the arrow keys, fill-in the budget fields provided. Grants are intended for travel, room and board as needed to establish the mentoring relationship. Grants are not intended for costs associated with meeting attendance or for the purchase of books. The mentorship committee will not consider any budgeted costs other than travel, room and board.

Upload Budget

Transportation $

Lodging $

Other $

Describe "Other"

Total Budget Request: $0.00 (USD)

Are you receiving or requesting funding from elsewhere? (e.g., another grant program) *

If so, please explain:

STATEMENT OF PURPOSE

Include the following points in a separate document that you should upload.

Describe your career goals.
Describe the goal(s) of the proposed mentorship and any specific project planned.
How do you envision this mentorship impacting your future career in hair research?
How will this experience specifically help prepare you to be a leader in hair research?

*(approx. 300-500 words)

Statement of Purpose *

CURRICULUM VITAE

Curriculum Vitae *

LETTERS

A letter from the proposed mentor to include a statement of willingness to provide the time necessary for this mentorship, any significant and pertinent details of the planned mentorship, and a specific mention of whether the time frame and budget are appropriate for the proposed mentorship.

Letter from proposed Mentor *

A letter from the department chair attesting to the applicant's character and potential to benefit from the mentorship.

Letter from applicant's department chair *

DEADLINE: November 30

AHRS Headquarters
1932 S. Halsted St., Suite 413
Chicago, IL 60608 USA
info@americanhairresearchsociety.org