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Francine Todd Memorial Occupational Radiation Safety and Protection Research Grant Application
Be sure to read the most current eligibility criteria for the Francine Todd Grant Award posted on the OSRT Web site. Complete and submit the online application and Project Description including all required elements by March 1. Upload the MS Word Doc, Docx, or PDF and click the submission button below after completing all required fields.
Primary Representative's Name(*)
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Street Address(*)
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Please enter a valid email of the form userid@email.com
Secondary Representative's Name
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Descriptive Title of Proposed Research(*)
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Name of Educational Program or Employer(*)
Name of educational program (students) or employer (RTs) required
Use the file mechanism below to upload the MS Word or PDF file that includes all required elements of the research project description (see rules).
Upload Project Description (MS Word or PDF only)
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ATTESTATION STATEMENT: I certify, to the best of my knowledge, the information on this application is complete and accurate. I understand that falsification of any information will cause my disqualification from the award competition. Further, I confirm that I meet all requirements for this application and am submitting all required documents as stated in the Francine Todd Grant Rules. I further confirm the project submitted is work solely of that of the applicant(s) listed, has not been prepared by another individual or commercial source and the research has not been previously professionally presented. I understand it is my responsibility to make sure the application process is complete by the required deadline. If not, the application may be disqualified from the awards competition and may not be considered for an award. This application, upon receipt, becomes the property of the Ohio Society of Radiologic Technologists (OSRT). I agree that, if selected as an award winner for the Francine Todd Memorial Occupational Radiation Safety and Protection Grant, the OSRT or its agents may use my name and likeness and any other information or materials provided in connection with this award for purposes of news, publicity and advertising in all media, including but not limited to print and electronic media, press releases, internet websites, and video media. If you are under 18, your parent or guardian must also agree to these Terms and Conditions.
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Form Verification(*) Form Verification Refresh
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