Thank you for your interest in the Shelby Jane Seyburn (SJS) Conference Grant program!

Please fill out this form completely and accurately. You may wish to draft your narrative in a separate document, and then copy-and-paste it into the textbox provided. (Note that no special formatting will be preserved)

Applicants will be notified within a few weeks of form submission.

For any questions, comments or concerns regarding this application, please contact to Dr. Kanako Taku at:
office phone: 248-370-2309; email:

Good luck!

  • Applicant's Name

  • Contact Information

  • Academic Information

  • Please enter a number greater than or equal to 2020.
  • Event Information

  • MM slash DD slash YYYY
  • Estimated Financial Assistance You Are Requesting

  • The items requested may include, but are not limited to:

    • Airfare
    • Lodging
    • Car and/or Local Transportation during event
    • Event registration or membership fees
    • Costs such as poster/handout printing
  • Note: Reward recipients will be required to submit receipts for all expenses incurred, as well as, proof of event attendance in order to receive financial reimbursement.

  • Grant Application History

  • Have you applied for or do you plan to apply for another grant for this event? If Yes: *

  • Note: If receiving funds from other grants, applicants will still be eligible for the SJS Travel Grant.

  • Include any background information, such any obstacles or experiences that you have had to overcome or that have helped you achieve your goals. Additionally, we would like to hear about any experiences with statistics and how statistics influences your work in the lab (if applicable).
  • Faculty Recommendation