4rth UVM Practical Course on Three-dimensional Cryo-electron Microscopy of Single Particles August 2-9, 2009, Burlington, VT APPLICATION FORM ________________________________________________________________________________ email this application to either: to truiz@physiology.med.uvm.edu, or mraderma@physiology.med.uvm.edu or fax to +1 802 656-0747 (Attn. either T. Ruiz or M. Radermacher) or mail to: Michael Radermacher, University of Vermont College of Medicine Dept. Molecular Physiology and Biophysics HSRF Building, Rm 120, Burlington, VT 05405, USA ________________________________________________________________________________ First name: Last name: Address: Telephone: Fax: E-mail: ________________________________________________________________________________ Short CV: ________________________________________________________________________________ Brief description of your intended research project related to this course (use additional page(s) if needed ): ________________________________________________________________________________