DI Publication Support

Date of Application *

mm/dd/yyyy

Investigator Member Last Name *

Investigator Member First Name *

College Affiliation *

Position *

Email Address *

Phone Number *

Journal Name/Publisher *

Publication Title *

Nonacademic or textbook publications, manuals, or fees from for-profit publishing organizations are not eligible. Manuscripts planned to be submitted for publication are not eligible.

Is the DI Investigator Member the first or senior author? *

List of All Authors

Total Cost of Publication *

Awards are up to $500 each and will support two publications per year, per investigator.

Amount Requested from DI *

Acceptance Letter or Email from the Publisher *

Drop your files here

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