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Submission Deadline is April 16, 2023 at 11:59 PM/CST.

First Name:

Last Name:

Email Address:

Sex:

Male
Female
I do not wish to answer.

Ethnicity:

Hispanic, Spanish, or Spanish origin
Not Hispanic, Spanish, or Spanish origin
I do not wish to provide ethnicity information.

Race (select all that apply):

American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
I do not wish to provide some or all of the above information.

Stage of Career:

Graduate Student
Postdoctoral Fellow
Fellow
Junior Faculty

Degree or Program (e.g., MS, MPH, PhD, MD, TPIR, etc.):

Degree field (e.g., Health Promotion Sciences, Cell Biology, Epidemiology, etc.):

Mentor's First Name:

Mentor's Last Name:

Mentor's Email:

Please upload all required application materials (Letter of Recommendation, Curriculum Vitae, Project Narrative, Supplemental Information) as a single .pdf file.

This award is intended to fund the following: 2 awards for trainees needing additional funding to support research efforts for a grant submission or resubmission (F-, K-, and R-series). Preference will be given to individuals who are revising and resubmitting their grant application (copy of summary statement and response to the statement will need to be included for resubmission applications), 2 additional trainees needing additional funding for their thesis/ dissertation/research project will also be supported.

Are you needing additional funding to support research efforts for a grant submission or resubmission (F-, K-, and R-series)?

Yes
No

Are you revising and resubmitting a grant application (copy of summary statement and response to the statement will need to be included for resubmission applications)?

Yes
No