NIH PREDOCTORAL FELLOWSHIP AWARDS FOR STUDENTS WITH DISABILITIES (F31)

Release Date:  February 24, 2000

PA NUMBER:  PA-00-068 (Expiration date extended, see NOT-OD-06-044)

Update: The following update relating to this announcement has been issued: July 21, 2006 - This PA has been reissued as PA-06-481.

EXPIRATION DATE: May 1, 2006, unless reissued. National Institutes of Health Application Receipt Dates: May 1 and November 15 PURPOSE This program announcement from the National Institutes of Health is for National Research Service Award (NRSA) Individual Predoctoral Fellowships for Students with Disabilities. It is a trans-NIH announcement that applies to all NIH funding components listed under INQUIRIES at the end of this announcement. The NRSA Predoctoral Fellowship for Students with Disabilities will provide up to five years of support for research training leading to the Ph.D. (or equivalent research degree), or the combined M.D./Ph.D. degree (or other combined professional research doctoral degrees) in the biomedical or behavioral sciences. The intent of this Predoctoral Fellowship Program is to encourage students with disabilities to seek graduate degrees and thus further the goal of increasing the number of scientists with disabilities who are prepared to pursue careers in biomedical and behavioral research. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS led national activity for setting priority areas. This Program Announcement (PA), Title of PA, is related to one or more of the priority areas. Potential applicants may obtain a copy of "Healthy People 2000" at http://odphp.osophs.dhhs.gov/pubs/hp2000. ELIGIBILITY REQUIREMENTS Citizenship. By the time of award, individuals must be citizens or noncitizen nationals of the United States, or have been lawfully admitted to the United States for permanent residence (i.e., possess a currently valid Alien Registration Receipt Card I-551, or other legal verification of such status). Noncitizen nationals are persons born in outlying possessions of the United States (e.g., American Samoa and Swains Island). Individuals on temporary or student visas are not eligible. Definition of Disability. For the purpose of this announcement, the definition of persons with disabilities from the Americans with Disabilities Act will be used. An individual with a disability is one who has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or who is regarded as having such an impairment." Qualified students with disabilities are those who, with reasonable accommodation for their disability, are capable of pursuing a research career after appropriate education, training, and experience. A list of disabilities that might confer eligibility for awards under this program includes, but is not limited to, the following: total deafness in both ears, visual acuity less than 20/200 with corrective lenses, speech impairment, missing extremities, partial paralysis, complete paralysis, convulsive disorders, mental or emotional illness, learning disabilities, kidney dialysis, and severe distortion of limbs and/or spine. In all cases, individuals supported under this program must, with reasonable assistance, be able to complete the requirements for the degree program in which they are enrolled. Degree Requirements. An applicant must currently be enrolled in a Ph.D. or equivalent research degree program, a combined M.D./Ph.D. program, or other combined professional doctorate/research Ph.D. graduate program in the biomedical, behavioral, or clinical sciences. Or, the applicant must have been accepted by and agreed to enroll in such a graduate program in the academic year for which funds are sought. Sponsor. The applicant must identify an individual who will serve as a sponsor or mentor and will supervise the training and research experience. The applicant’s sponsor should be an active investigator in the area of the proposed research who will directly supervise the candidate’s research. The sponsor must document the availability of staff, research support, and facilities for high-quality research training. The applicant must work with his/her sponsor in preparing the application. Foreign Sponsorship. Applicants requesting foreign training must show in the application that the foreign institution and sponsor offer unique opportunities that are not currently available in the United States. Only if there is a clear scientific advantage will foreign training be supported. Institution. The sponsoring institution may be private (profit or non-profit) or public. MECHANISM OF SUPPORT This program announcement for the individual Predoctoral Fellowship Award For Students with Disabilities (F31) is issued under the auspices of the NRSA Act (see AUTHORITY AND REGULATIONS). The period of fellowship support requested in response to this program announcement may not exceed five years. Continuation of the fellowship award for each subsequent year beyond the first year of the award is based upon evidence of satisfactory progress in a graduate program. (Note: the total period of predoctoral training support by statute is limited to 5 years by statute, 42 USC 288, with a provision for waiver of the limit in unusual circumstances. If the recipient of a predoctoral fellowship seeks a waiver of the five-year limit, a request must be submitted in writing to the funding NIH Institute or Center documenting the conditions that might justify an extension.) Awards will be administered under the NIH Grants Policy Statement found at http://grants.nih.gov/grants/policy/policy.htm, and the NRSA Guidelines for Individual Awards and Institutional Grants, available on the NIH website at http://grants.nih.gov/training/nrsaguidelines/nrsa_toc.htm. The proposed NRSA training must be within the scope of biomedical, behavioral, or clinical research and must offer an opportunity for individuals to broaden their scientific background or to extend their potential for research in health-related areas. Individuals are required to pursue their research training on a full-time basis, devoting at least 40 hours per week to the training program. ALLOWABLE COSTS Stipend. The fellowship award provides an annual stipend to help meet the fellow's living expenses; an allowance for tuition, fees and health insurance in accordance with NIH policy; and an institutional allowance. The stipend amount is updated periodically and applicants are advised to search the NIH Guide for Grants and Contracts for the most current rate or for the posting of the current stipend on the NIH website at http://grants.nih.gov/training/nrsa.htm. In FY 2000, the NRSA stipend is $15,060. The awarding NIH institute or center will adjust awards as the stipend is changed. Tuition, Fees, and Health Insurance. The NIH will offset the combined cost of tuition and fees and self-only or family health insurance (as appropriate) at the following rate: 100 percent of all costs up to $3,000 and 60 percent of costs above $3,000. Costs associated with tuition and fees are allowable only if they are required for specific courses in support of the research training experience supported by the fellowship. A full description of the tuition policy is contained within the NRSA Policy Guidelines on the NIH website at http://grants.nih.gov/training/nrsa.htm. Institutional Allowance. An institutional allowance of $2,500 per 12-month period will be awarded to non-Federal, non-profit sponsoring institutions to help defray such awardee expenses as research supplies, equipment, travel to scientific meetings, and related items. This allowance is intended to cover training-related expenses for the individual awardee and is not available until the fellow officially activates the award. If the fellow is not enrolled or engaged in training for more than 6 months of the award year, only one-half of that year’s allowance may be charged to the grant. The Notice of Research Fellowship Award will be revised, and the balance must be refunded to the NIH. Reasonable Accommodations. As a part of these awards, additional funds may be requested to make changes or adjustments in the academic or research environment that will make it possible for an otherwise qualified individual to perform the work necessary to meet the requirements of the degree program in which he/she is enrolled. The accommodations requested under this program must be directly related to the work required to meet the requirements of the degree program as regards both course work and laboratory experience, and must be appropriate to the special needs of the applicant. Some types of accommodations that might be provided under these awards include, but are not limited to: specialized equipment, assistive devices, and personnel such as readers, interpreters, or assistants. In all cases, the total funds requested for accommodations must be reasonable in relationship to the total costs of the fellowship award. This award is not meant to relieve the sponsoring institution of its obligation to provide reasonable accommodations as defined by the Americans with Disabilities Act. NIH will not provide funds for infrastructure alterations such as lowering countertops, widening doorways, etc. Other Training Costs. Additional funds may be requested by the institution if the training of a fellow involves extraordinary costs for travel to field sites remote from the sponsoring institution. Funds are not available to cover the cost of travel between the fellow's place of residence and a training institution. However, in cases of extreme need or hardship, a one-way travel allowance may be authorized by the awarding component. Such travel must be paid from the institutional allowance. Awards for training at a foreign site may include a single economy or coach round-trip travel fare. No allowance is provided for dependents. U.S. flag carriers must be used to the maximum extent possible when commercial air transportation is available for travel between the United States and a foreign country or between foreign countries. Facilities and Administrative Costs. F&A (indirect) costs are not allowed on individual fellowship awards. STIPEND SUPPLEMENTATION, COMPENSATION AND OTHER INCOME An institution is permitted to provide funds to a fellow in addition to the stipend paid by the NIH. Such additional amounts may be in the form of augmented stipends (supplementation) or compensation for services. Supplementation. Supplementation or additional support to offset the cost of living may be provided by the sponsoring institution, but must not require any additional effort from the fellow. Federal funds may not be used for supplementation unless specifically authorized under the terms of both the program from which such supplemental funds are to be received and the program whose funds are to be supplemented. Under no circumstances may PHS grant funds be used for supplementation. Compensation. An institution may provide additional funds to a fellow in the form of compensation (as salary and/or tuition remission) for services, such as teaching or research. Compensation for services is not considered stipend supplementation. A fellow may receive compensation for services as a research assistant or in some other capacity on a Federal research grant, including a PHS research grant. However, compensated services must occur on a limited, part-time basis apart from the normal training activities, which require a minimum of 40 hours per week. In addition, compensation may not be paid from a research grant supporting research that is part of the F31 research training experience. Under no circumstances may the conditions of stipend supplementation or the services provided for compensation interfere with, detract from, or prolong the fellow's approved NRSA training program. Additionally, compensation must be in accordance with institutional policies applied consistently to both federally and non-federally supported activities and supported by acceptable accounting records determined by the employer-employee relationship agreement. Educational Loans or G.I. Bill. An individual may make use of Federal educational loan funds and assistance under the Veterans Readjustment Benefits Act (G.I. Bill). Such funds are not considered supplementation or compensation. Concurrent Awards. An F31 may not be held concurrently with another Federally sponsored fellowship or similar Federal award that provides a stipend or otherwise duplicates provisions of the NRSA. Tax Liability. The Internal Revenue Code, Section 117, applies to the tax treatment of all scholarships and fellowships. Degree candidates may exclude from gross income reported for tax purposes any amount used for tuition and related expenses, such as fees, books, supplies, and equipment, required for courses of instruction at a qualified educational organization. The taxability of stipends, however, in no way alters the relationship between NRSA fellows and institutions. NRSA stipends are not considered salaries. NRSA fellows are not considered to be in an employee-employer relationship with the NIH or with the institution in which they are pursuing their degree. The interpretation and implementation of the tax laws are the domain of the Internal Revenue Service (IRS) and the courts. The NIH takes no position on what the status may be for a particular taxpayer, and it does not have the authority to dispense tax advice. Individuals should consult their local IRS office about the applicability of the law to their situation and for information on the proper steps to be taken regarding their tax obligations. The business office of the sponsoring institution is responsible for the annual preparation and issuance of IRS form 1099 (Statement of Miscellaneous Income) for fellows paid through the institution. NIH will issue the form for all fellows training at Federal or foreign laboratories and receiving a stipend check from the U.S. Treasury. PAYBACK There are no payback requirements for predoctoral NRSA support. LEAVE Predoctoral fellows may continue to receive stipends during periods of vacation and holidays available to individuals in comparable training positions at the sponsoring institution. Also, predoctoral fellows may continue to receive stipends for up to 15 calendar days of sick leave per year. Sick leave may be used for the medical conditions related to pregnancy and childbirth. Fellows may continue to receive stipends for up to 30 calendar days of parental leave per year for the adoption or the birth of a child when those in comparable training positions at the grantee or sponsoring institution have access to paid leave for this purpose and the use of parental leave is approved by the sponsor. A period of terminal leave is not permitted and payment may not be made from grant funds for leave not taken. Individuals requiring extended periods of time away from their research training experience must seek approval from the NIH awarding component for an unpaid leave of absence. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the "NIH Guidelines For Inclusion of Women and Minorities as Subjects in Clinical Research," which have been published in the Federal Register of March 28, 1994 (FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23, No. 11, March 18, 1994 available on the web at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not94-100.html INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them. This policy applies to all initial (Type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the "NIH Policy and Guidelines on the Inclusion of Children as Participants in Research Involving Human Subjects" that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html Investigators also may obtain copies of these policies from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. APPLICATION PROCEDURES Individuals must submit the application form, PHS Individual National Research Service Award (PHS 416-1, rev. 12/98), and include at least three letters of reference. If the applicant has been lawfully admitted to the United States for permanent residence, the appropriate item should be checked on the Face Page of the application. Applicants who have applied for and have not yet been granted admission as a permanent resident should check the Permanent Resident block on the Face Page of the PHS 416-1 application, and also write in the word “pending”. A notarized statement documenting legal admission for permanent residence must be submitted prior to the issuance of an award. Potential applicants are STRONGLY ENCOURAGED to consult with one of the NIH staff listed under INQUIRIES prior to submitting an application. Applicants should identify a faculty mentor/sponsor to help them determine the most appropriate NIH institute, and staff member to contact. The applicant must follow all general instructions in the application kit AND the specific instructions included in the APPENDIX to this program announcement. All fellowship applications submitted in response to this Program Announcement must identify the number PA-00-068 in Item 3. In addition to the information requested in the application kit (Form 416-1), the following MUST be included with the application at the time of submission. Failure to include any of these items may delay review of the application: o THREE reference letters in sealed envelopes must be affixed to the original face page of the application. The sponsor cannot be used as a reference. APPLICATIONS SUBMITTED WITHOUT THREE REFERENCE LETTERS WILL BE RETURNED WITHOUT REVIEW. o a copy of the results of either the Graduate Record Examination or the Medical College Admission Test (for M.D./Ph.D. applicants) must be included at the end of the application; o a clear and legible copy of the applicant's transcript(s) from all undergraduate and graduate institutions in which the applicant is/has been enrolled must be included at the end of the application; o a description of the graduate or combined degree program in which the applicant is either enrolled or has been admitted and agreed to enroll must be included as Item 34 of the application. o a description of plans to receive instruction in the responsible conduct of research must be included in Item 34. No award will be made if an application lacks this component. Application Materials. To obtain application kits with instructions and forms, please contact your institutional office of sponsored research. If application kits are not available at the institution, they may be downloaded from the NIH website at http://grants.nih.gov/grants/forms.htm or they may be requested from: Extramural Outreach and Information Resources Office Office of Extramural Research National Institutes of Health 6701 Rockledge Drive, Room 6207 MSC 7910 Bethesda, MD 20892-7910 Telephone: (301) 435-0714 For faster service, send Email requests to grantsinfo@nih.gov . Please allow 2-4 weeks for U.S. mail requests. Concurrent Applications. An individual may not have more than one individual NRSA fellowship or comparable application pending review or award at the NIH or other DHHS agencies at the same time. Application Receipt Dates and Review Schedule. F31 applications undergo an expedited review that takes approximately five months. The two annual review cycles are as follows: Application Receipt Dates: May 1 Nov 15 Initial Review Date: Jun/Jul Feb/Mar Secondary Review Date: Aug/Sep Apr/May Earliest Possible Start Date: Sep 1 May 1 Note that this schedule differs from the schedule given in the PHS 416-1 instructions. INCOMPLETE APPLICATIONS WILL NOT BE REVIEWED. SUBMISSION Submit a signed, typewritten original of the application (including the Checklist, Personal Data form, at least three sealed reference letters, and all other required materials) and two (2) exact, clear, single-sided photocopies of the signed application, in one package to: CENTER FOR SCIENTIFIC REVIEW NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 MSC 7710 BETHESDA, MD 20892 BETHESDA, MD 20817 (express mail) (a mailing label is included in the PHS 416-1 application kit) REVIEW CONSIDERATIONS Complete applications will be assigned to the appropriate participating Institute and a suitable Scientific Review Group (SRG) in the Center for Scientific Review (CSR). Applicants will be notified of their application's Institute and SRG assignment. Applications receive two sequential levels of review. The first level is an assessment of the merit of the research training by an SRG, composed primarily of non-government scientists selected for their competence in research and research training in a particular scientific area. After the SRG meeting, the Scientific Review Administrator (SRA), a designated Federal official who coordinates the review of applications for the SRG, prepares a written summary of the review of each application and forwards it to the appropriate NIH institute. A second level of review is provided by staff within the assigned funding Institute or Center. Review Criteria The review criteria include: o the quality of the academic record and the prior research experience of the applicant as well as the potential for independent contributions to scientific knowledge; o the quality of the graduate program in which the applicant is enrolled or has been accepted for enrollment; o the qualifications and the research/research training experience of the applicant's sponsor or research advisor; o the match between the research interests of the student and the research advisor/sponsor and the quality of the career development plan; o the quality of the research training plan including the plan to receive training in the responsible conduct of research; and o for advanced graduate students, scientific significance, originality, and feasibility of the proposed research; for beginning students, quality and clarity of stated research interests. Notification. Shortly after the SRG meeting, each applicant will be notified of the SRG recommendation and the name and phone number of the Institute program official responsible for the application. When the program official representing the Institute receives the written summary of the review, prepared by the SRA after the review meeting, a copy will be forwarded to the applicant. Following the second-level review, the program official will notify each applicant of the final disposition of his/her application. Any questions on SRG recommendations and funding possibilities should be directed to the appropriate Institute program official, not the Scientific Review Administrator of the SRG. AWARD CRITERIA The staff of the NIH Institutes use the following criteria in making awards: (1) eligibility of the applicant; (2) the SRG recommendation of the overall merit of the application; (3) the relevance of the application to the Institute's research priorities and program balance; and (4) the availability of funds. Activation. No funds may be disbursed until the fellow has started training under the award and an Activation Notice (PHS 416-5) has been submitted to the NIH. An awardee has up to 6 months from the issue date on the Notice of Research Fellowship Award to activate the award. Under unusual circumstances, an Institute may grant an extension of the activation period upon receipt of a specific request from the fellow. TERMS AND CONDITIONS OF SUPPORT Fellowships must be administered in accordance with the current NRSA Policy (found on the NIH website at http://grants.nih.gov/training/nrsaguidelines/nrsa_toc.htm), the current PHS Grants Policy Statement (see the NIH website at http://grants.nih.gov/grants/policy/policy.htm), and any terms and conditions specified on the Notice of Research Fellowship Award. Certification and Reporting Procedures. No application will be accepted without the applicant signing the certification block on the face page of the application. Individuals admitted to the United States as permanent residents must submit notarized evidence of legal admission prior to the award. When support ends, the fellow must submit a Termination Notice (PHS 416-7) to the NIH. Forms will be provided to the awardees by the NIH awarding component. Forms may also be found on the NIH Website at http://grants.nih.gov/grants/forms.htm. Inventions and Publications. Fellowships made primarily for educational purposes are exempted from the PHS invention requirements. F31 awards will not contain any provision giving PHS rights to inventions made by the awardee. Data Sharing. PHS Policy is to make available to the public the results and accomplishments of the activities that it funds. Therefore, it is incumbent upon fellows to make results and accomplishments of their F31 activities available to the public. There should be no restrictions on the publication of results in a timely manner. Copyrights. Except as otherwise provided in the terms and conditions of the award, the recipient is free to arrange for copyright without approval when publications, data, or other copyrightable works are developed in the course of work under a PHS grant-supported project or activity. Any such copyrighted or copyrightable works shall be subject to a royalty-free, nonexclusive, and irrevocable license to the Government to reproduce, publish, or otherwise use them, and to authorize others to do so for Federal Government purposes. AUTHORITY AND REGULATIONS NRSAs are made under the authority of Section 487 of the Public Health Service Act as amended (42 USC 288), and Title 42 of the Code of Federal Regulations, Part 66. The following Catalog of Federal Domestic Assistance numbers are applicable to these awards: 93.121, 93.172, 93.173, 93.233, 93.272, 93.278, 93.282, 93.306, 93.361, 93.398, 93.821, 93.837-93.839, 93.846-93.849, 93.853- 93.856, 93.859, 93.862-93.867, 93.880, 93.894, and 93.929. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. INQUIRIES For additional information contact the appropriate individual listed below. All individuals listed below can be reached via the Federal Information Relay System, 1 (800) 877-8339. National Institute on Aging (NIA) Dr. Robin Barr Telephone: (301) 496-9322 Email: rb42h@nih.gov National Institute on Alcohol Abuse and Alcoholism (NIAAA) Dr. Ernestine Vanderveen Telephone: (301) 443-1273 Email: tv9f@nih.gov National Institute of Allergy and Infectious Diseases (NIAID) Dr. Milton Hernandez Telephone: (301) 496-3775 or (800) 380-3876 Email: mh35c@nih.gov National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Dr. Richard Lymn Telephone: (301) 594-5128 Email: rl28b@nih.gov National Cancer Institute (NCI) Dr. Eric J. Bailey Telephone: (301) 496-7344 Email: eb157o@nih.gov National Institute of Child Health and Human Development (NICHD) Dr. Steven Klein Telephone: (301) 496-5541 Email: sk5d@nih.gov National Institute on Deafness and Other Communication Disorders (NIDCD) Dr. Daniel Sklare Telephone: (301) 496-1804 Email: ds104i@nih.gov National Institute of Dental and Craniofacial Research (NIDCR) Dr. James Lipton Telephone: (301) 594-2618 Email: jl46d@nih.gov National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Division of Digestive Diseases and Nutrition Dr. Judith Podskalny Telephone: (301) 594-8876 Email: jp53s@nih.gov Division of Diabetes, Endocrinology, and Metabolic Diseases Dr. Ronald Margolis Telephone: (301) 594-8819 Email: rm76f@nih.gov Division of Kidney, Urologic, and Hematologic Diseases Dr. Charles Rodgers Telephone: (301) 594-7726 Email: cr36d@nih.gov National Institute on Drug Abuse (NIDA) Division of Basic Research Dr. Charles Sharp Telephone: (301) 443-1887 Email: cs107m@nih.gov National Institute of Environmental Health Sciences (NIEHS) Dr. Carol Shreffler Telephone: (919) 541-1445 Email: cs63v@nih.gov National Eye Institute (NEI) Dr. Maria Giovanni Telephone: (301) 496-0484 Email: mg37u@nih.gov National Institute of General Medical Sciences (NIGMS) Dr. Anthony A. Rene Telephone: (301) 594-3833 Email: ra50h@nih.gov National Heart, Lung, and Blood Institute (NHLBI) Mrs. Ann Rothgeb Telephone: (301) 435-0202 Email: ar31t@nih.gov National Institute of Mental Health (NIMH) Henry Khachaturian, Ph.D. Telephone: (301) 443-4335 Email: hk11b@nih.gov National Institute of Neurological Disorders and Stroke (NINDS) David A. Jett, Ph.D. Program Director, Office of Minority Health and Research NSC, Suite 2149 Bethesda, MD 20892 Rockville, MD 20852(For Express/Courier Service) Telephone: (301) 496-3102 FAX: (301) 594-5929 Email: dj140o@nih.gov National Institute of Nursing Research (NINR) The National Institute of Nursing Research has an ongoing Program Announcement for NINR National Research Service Award Individual Predoctoral Fellowships (F31) that is also an appropriate funding opportunity for nursing students with disabilities. Information about this announcement and other aspects of our research training program is found at http://www.ninr.nih.gov/ Inquiries about this program should be directed to: Dr. Nell Armstrong Telephone: 301-594-5973 nell_armstrong@nih.gov National Human Genome Research Institute (NHGRI) Dr. Bettie Graham Telephone: (301) 496-7531 Email: bg30t@nih.gov National Center for Research Resources (NCRR) Dr. David Wilde Telephone: (301) 435-0799 Email: dw171w@nih.gov National Center for Complementary and Alternative Medicine Dr. Neal West Telephone: (301) 402-5867 Email: nw20a@nih.gov If you are not certain whom to contact, contact: Walter T. Schaffer, Ph.D. Research Training Officer National Institutes of Health 6701 Rockledge Drive, Room 6184 Bethesda, Maryland 20892-7911 Phone: 301-435-2687 FAX: 301-480-0146 EMail: ws11q@nih.gov APPENDIX Instructions for Completing the Application A. To be completed by the student-applicant (Form Page 1) Item 1. ("Title of Research Training Proposal"). Type: PREDOCTORAL FELLOWSHIPS FOR STUDENTS WITH DISABILITIES Item 2. ("Level of Fellowship"). Type: Predoctoral. Item 3. ("Program Announcement Number"). Type: PA-00-XXX Items 4 - 8. Self-explanatory. Item 4j ("Citizenship"). By the time of the award, individuals must be citizens or non-citizen nationals of the United States, or must have been lawfully admitted to the United States for permanent residence (i.e., possess a currently valid Alien Registration Receipt Card I-551, or other legal verification of such status). Non-citizen nationals are generally persons born in outlying possessions of the United States (e.g., American Samoa and Swains Island). Individuals on temporary or student visas are not eligible. If permanent residence status is pending when the application is submitted, place an X in the box for permanent resident and type “pending”. (Items 9 - 14. Completed by sponsor). Item 15. THE APPLICANT MUST SIGN THE APPLICATION. (Form Page 2) Items 16-18. Self-explanatory; if any do not apply to you, type N/A. (Items 19, 20, and 21. Completed by sponsor) Item 22. (Abstract of Proposed Research). If you have selected a thesis topic, briefly describe, in abstract form, the question you are studying, how you are approaching it, and the health relatedness of your project. If you have not yet selected a thesis project, type "No thesis selected," and instead give a brief description of the research area that interests you most, even if your research interests are still very broad, and why. (Form Page 3) Fill in the appropriate page numbers in the spaces provided. (Form Page 4) Item 23. (Scholastic Performance). List all undergraduate and graduate courses you have taken and the grades you received. In addition, you MUST submit a LEGIBLE copy of a transcript from all undergraduate and graduate institutions you have attended or are currently attending. (Form Page 5) Items 24, 25,27. Self-explanatory Item 26. Complete only if the dissertation advisor is different from the sponsor. (Form Page 6) Item 28. Research Experience a. (Summary). Provide a thorough description of your relevant work and research experiences, including time, place, research director, and your role in the research. b. (Doctoral Dissertation). Leave blank. c. (Publications). Include a list of publications, abstracts, and poster presentations. Three (3) collated sets of copies of publications may be provided as part of Section 3 (Appendix), per instructions on page 3. Item 29. (Revised Application). Complete ONLY if this application is a revision of an application submitted earlier. Limit this to 1 page. Item 30. (Research Training Plan) a. (Activities Under Award). Explain your research training and long-range career goals and how the proposed course of study to be supported by this fellowship will help you attain these goals. If appropriate, explain how prior work and research experiences affected your choice of career goals. b. and c. (Research Proposal and Respective Contributions). If you have selected a research thesis topic, complete this section according to the instructions. If you have not yet selected a thesis, give a description of the research area that interests you most and why. d. (Selection of a Sponsor and Institution). Explain why you chose to enroll in this university/institution and in this graduate program. If you have selected a research advisor, give the rationale for your choice. If you have not selected an advisor, identify up to five individuals with whom you would like to work, giving a rationale for your choices. B. To be completed by the research advisor or sponsor If the applicant HAS SELECTED A RESEARCH ADVISOR, the ADVISOR must complete the items in this section. If the applicant HAS NOT YET SELECTED A RESEARCH ADVISOR, the director of the graduate program should designate a sponsor to complete these items. The director may choose to serve as the sponsor. For Items 9-14 on Form Page 1, items 19-21 on Form Page 2, and items 30-38 on Form Pages 6 through 8, follow the instructions in the 416-1 kit. In Item 34, in addition to the information requested in the application kit: (1) provide a full description of the graduate or combined degree program in which the applicant is (or is to be) enrolled. This description should give both the normal course of study (both didactic and laboratory) for students enrolled in the program AND the specific training plan for the applicant. A description of opportunities to receive training in the responsible conduct of research must also be included; (2) for students ALREADY ENROLLED in the graduate program, describe the applicant's course of study up to the time of submission of the application and plans for further study; and (3) provide the applicable tuition and fees for each year of support requested. Such tuition and fees must be those charged to all similar individuals regardless of source of support. C. To be supplied by the university or institution A signed statement from the institution certifying: the applicant is enrolled as a predoctoral student OR has been accepted by and agreed to enroll in the graduate training program; the applicant is a citizen, non-citizen national or permanent resident of the U.S. (see ELIGIBILITY REQUIREMENTS, at the beginning of this Announcement); the applicant is an eligible individual with a disability (This certification MAY include a description of the applicant’s disabling condition, the occupational limitations of the applicant, any accommodations required, the institution’s contribution to those accommodations, and any costs requested from the NIH). FAILURE TO INCLUDE THIS CERTIFICATION MAY DELAY REVIEW OR AWARD. 2. By signing Item 38 (Form Page 8), the institution is certifying the accuracy of the information provided.


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