Translational Working Group Application
Please complete application by filling out the requested information below. Submitted applications are reviewed by the Masonic Cancer Center Executive Committee.

For questions or concerns regarding this form, please contact the TWG Administrator, Eric Zhang, at zhan0718@umn.edu or 612-625-0458.

Translational Working Group
Name of Proposed Translational Working Group *
Group Leader Information
Leader Name *
Leader Email *
Leader Phone Number *
Leader Office Location *
Executive Committee Information
Please list each in corresponding order.

eg. name #1 should correspond to email #1, phone #1, etc.

Names *
Emails *
Phone Numbers *
Office Locations *
Administrator Information
Administrator Name *
Administrator Email *
Administrator Phone Number *
Administrator Office Location *
Proposed Members
List of Proposed Members *
Details of Group Activities
Please go in to detail describing planned group activities of your proposed TWG
Executive Committee Meetings - recommended to meet at least twice a year *
Data Club / Project Development Meetings - recommended to meet at least 8 times a year *
Current or Proposed Translation Projects *
Key Clinical Projects - Planned or in Progress *
Local Seed Grants - Existing, Proposed, or Planned Applications for Research Support *
Long-term Funding Goals - Grant Support, Philanthropic Support *
Other Activities: *
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