2017 Joanne Angle Investigator Award Application Form

Project Title and Contact Information

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50% of survey complete.

The Joanne Angle Investigator Award provides funding for research investigating public health related to eye health and safety. The Award is funded by Prevent Blindness.

This application form must be completed online in one session.

All fields are required.

Four (4) additional files are required - please attach as pdf documents and email to Nita Sinha, npatelsinha@preventblindness.org.

- Information about Principal Investigator, and Required Signatures (form).

- Description of Research Project

- One Year Budget (form)

- Signed Letter of Recommendation

All files must be received prior to the deadline.

Deadline for completing this application is Monday, March 6, 2017, at 12 p.m. ET.

Question Title

* 1. Project Title

Question Title

* 2. Project Topic Area

Question Title

* 3. How does your project fit into the Project Topic Area selected in Question 2

Question Title

* 4. Principal Investigator

First Name

Middle Name

Last Name

Degree(s)

Phone

Citizenship

Current Position

Institution

Department

Address

City

State

Zip

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* 5. Department Head

First Name

Middle Name

Last Name

Degree(s)

Phone

Position

Institution

Department

Address

City

State

Zip

Question Title

* 6. Administrative Official

First Name

Middle Name

Last Name

Degree(s)

Phone

Position

Institution

Department

Address

City

State

Zip