<p> Medical Imaging Alumni Research Promotion Award APPLICATION</p><p>Application Deadline: May 12, 2017</p><p>Name: Click here to enter text.</p><p>Hospital of Primary Appointment: Click here to enter text.</p><p>Division: Click here to enter text.</p><p>Title of Planned Research: Click here to enter text.</p><p>Names and appointments of Click here to enter text. co-researchers (if any):</p><p>Current funding held for this project Click here to enter text. (if any):</p><p>Description of project plans:</p><p>Click here to enter text.</p><p>Project Budget: Click here to enter text. How do you intend to use the Award funds?</p><p>Click here to enter text.</p><p>Anticipated time frame for Click here to enter text. completion of project:</p><p>What resources will be required and how will you access these resources (if hospital resources are required you must discuss requirements with your Department Chief in advance of making this application)?</p><p>Click here to enter text.</p><p>How will your project benefit medical imaging science? </p><p>Click here to enter text. Do you expect outcomes of your project will lead you to further research?</p><p>Click here to enter text.</p><p>RETURN COMPLTED APPLICATIONS TO: (by email, fax or mail)</p><p>Department of Medical Imaging University of Toronto 263 McCaul Street, 4th Floor Toronto, ON M5T 1W7 Fax: 416-978-6915 Email: [email protected] DEADLINE: May 12, 2017</p><p>Medical Imaging Alumni Research Promotion Award Application Page 2</p>