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R33 HIV and Aging Concept Proposal Submission
Please complete all required fields!
First Name
(*)
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Last Name
(*)
Please let us know your name.
Email Address
(*)
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Degree(s)
(*)
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Year Degree(s) Granted
(*)
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Please identify your home institution where funds will be sent
(*)
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I verify that I currently hold a faculty position at my institution
(*)
Yes
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Academic Position or Title (For example: Assistant Professor)
(*)
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An Early Stage Investigator is within 10 years of completing his/her terminal research degree or is within 10 years of completing medical residency (or the equivalent).
Do you qualify to be an Early Stage Investigator (ESI) according to the NIH Definition
(*)
Yes
No
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Proposed Project Title
(*)
Please list 5 key words describing your project
(*)
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Does your home institution have a NIH-funded Center for AIDS Research (CFAR), a Claude D. Pepper Older Americans Independence Center (Pepper Center) and/or a Nathan Shock Center?
(*)
CFAR
Pepper Center
Nathan Shock Center
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Do you have identified HIV or Aging co-investigator(s) for you project?
(*)
Yes
No
I would like assistance identifying a co-investigator
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If yes, please type the name(s) of your co-investigator(s)
(*)
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Check the following CFAR, OAIC, and NSC resources that are applicable to your project
(*)
Core Services
Humann Specimen Repositories
Animal Specimen Repositories
Equipment usage
CFAR sponsorship
Other
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Will any of your research be conducted outside of the U.S.?
(*)
Yes
No
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If I am selected to submit a full proposal, I acknowledge that matching funds from my home CFAR or OAIC is preferred, but not required. If my CFAR or OAIC will match, I will provide a letter of support detailing this agreement with my full proposal submission from my home CFAR or OAIC.
(*)
Yes, I agree to provide a Letter of Support for matching funds
No, I will not have matching funds from my home CFAR or OAIC
Upload two-page concept proposal and NIH Biosketch in a PDF file here.
(*)
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(*)
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