ADS ASM Awards Application Form

I am a junior investigator/early career researcher Yes No

My abstract is an Oral Presentation or Poster Presentation

My abstract is for Basic Science or Clinical Research

Are you applying for the ADS President’s Young Investigator Award Yes No

Are you applying for the ADS-Pincus Taft Young Investigator Award Yes No

Are you applying for an ADS Poster Award Yes No

Are you currently not more than 2 years beyond the award of a doctoral degree (PhD, MD)
or Fellowship (FRACP) Yes No

Are you a current financial ADS Member (Paid to 2017) Yes No