Multimodal Neuroimaging Training Program

Application

• Complete the application here.
• Submit a copy of your CV within the on-line application process.
• Submit a brief (2 page) essay describing your neuroimaging experience, interest and goals in participating in the workshop.
• Arrange one reference letter to be submitted directly to MNTP Coordinator at: mntp@pitt.edu.



Last Name:
First Name:
E-mail:
Street Address:
City:
State:
Zip Code:
Country:
Daytime Phone:
Evening Phone:
Sex:	Please Select Male Female
Race :	Please Select African American American Indian or Alaska Native Asian or Pacific Islander Caucasian Hispanic Other
Current Institution:
Current Position:	Please Select Graduate Student Medical Student Postdoc Resident Faculty Other
Visa Status and dates (If applicable)
Current plan and prior research experience (No more than two pages)
Proficiency of Unix or Linux	Please Select Well Little None
Proficiency of Matlab Program	Please Select Well Little None
What imaging software are you familiar with ? (e.g. AFNI,Stimulate)
How did you hear about the MNTP Summer Workshop
Rank top two modalities. Choice of imaging modality must be different from the techniques you already have expertise in.	Select 1st choice DTI fMRI MEG/EEG PET Near IR Spectroscopy Animal Optical Imaging
Copy and paste your Resume or Curriculum Vitae in the text box: .