Trainee Publication Award Request Form

Please fill out this form to request Trainee Publication Award support.

Name:*

Email Address:*

Are you currently a: *

Are you the first or corresponding author of the publication?*

List the article title and full author list with affiliations.*

List any SMHS associated PI/mentor/corresponding authors for the publication.*

List the Pubmed indexed journal the article has been accepted into.*

Attach the official manuscript acceptance letter and associated publication fee request from the journal.*