Confirm attendance to the 2012 NOYCIA Event

Apply to NOYCIA

Call for Abstracts

Complete the application form including a copy of your abstract, your supervisors letter and your letter of acceptance from ASCO. Describe your actual contribution to the project. What is the relative contribution to the project in terms of percentage compared to the other authors?

You will receive an e-mail confirmation of your application.

All abstracts will be reviewed by an independent committee, who will select the 10 winners. All applicants will be notified in May.

The winners will be asked to provide a presentation of 5 slides summarizing their abstracts for ASCO at the NOYCIA awards dinner on June 3, 2012.

General timelines for 2012:


Application Form

All fields are mandatory

Last Name:
 

Business Telephone Number:
ext.

First Name:
 

Business Facsimile Number:

Business E-Mail Address:

Confirm Business E-Mail Address:

Present Title at Institution:
(e.g.: Medical Research Fellow)

 

Present Institution Name:

 

Supervisor Title:
 

Supervisor Name:
 

Business Address

Preferred Mailing Address
(check box if different from Business Address)

Business Name:
 

Business Name:

Apt/Suite Number:

Apt/Suite Number:

Address:
 

Address:

City:
 

City:

Province:
 

Province:

Postal Code:
 

Postal Code:

Upload Abstract Submission (Word Doc or PDF)
 

Upload Supervisor Letter (Word Doc or PDF)
 

Upload ASCO acceptance letter (.jpeg, .doc or .pdf)
 

Describe your actual contribution to the project.:
 

What is the relative contribution to the project in terms of percentage compared to the other authors?:
 

I attest that all of the information presented above is accurate, to the best of my knowledge.  

Date (dd/mm/yyyy)