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Graduate Student Training Programs Application

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OMB: 0925-0501

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ATTACHMENT – 2



Application, Letter of Recommendation, and Evaluation Form

<Web Page>

Graduate Student Training Programs Application

OMB No. 0925-0501

Expiration Date: XXXX XX, XXXX (Expiration Date is Not the Application Deadline.)


The GPP encourages you to review the following information before completing the on-line application:

  • Application Directions

  • Frequently Asked Questions

  • Application Help

  • Privacy Statement

  • Respondent Burden


To complete your application to the GPP, the following items are needed:


  1. Three letters of recommendation from three individuals that can evaluate your strengths as a future PhD: submitted electronically by the references as directed in the email request.


  1. Unofficial Copy of Standardized Examination Scores: may be submitted by mail or fax


  1. Official Copy of All Transcripts: submitted by university registrar or by the applicant in sealed & signed envelops from the registrar.


YOUR APPLICATION WILL NOT BE CONSIDERED UNLESS ALL REQUIRED APPLICATIONS AND SUPPLEMENTAL MATERIAL ARE RECEIVED BY THE SPECIFICED DEADLINE LISTED IN THE PARTNERSHIP DESCRIPTION.


After completing the on-line application, send items 2 and 3 to the address listed below.

Graduate Partnerships Program

ATTN: APPLICATION MATERIAL

National Institutes of Health

2 Center Drive: Building 2 / Room 2E06

Bethesda, Maryland 20892-0234

Phone: 301-594-9605

Fax: 301-594-9606

Email: [email protected]

Web: http://gpp.nih.gov


Please, No Staples!


<Web Page>


Privacy Policy


Collection of this information is authorized under 42 U.S.C. 203, 241, 2891-1 and 44 U.S.C. 3101. The primary use of this information is to evaluate your qualifications for research training at the National Institutes of Health. Additional disclosures may be made to law enforcement agencies concerning violations of law or regulation. Application for this program is voluntary, however, in order for us to process your application; you must complete the required fields.


<Web Page>


Respondent Burden


Public reporting burden for this collection of information is estimated to average 30 minutes per responses, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974. ATTN: PRA (0925-0501). Do not return the completed form to this address.



PERSONAL INFORMATION

Greeting title

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First name


Middle name


Last name


Date of birth

Month / Date / Year

Are you a USA Citizen?

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If not a USA Citizen, are you a USA Permanent Resident?

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If International Citizen, what is your country of citizenship?


If International Citizen, what visa do you have for admission into the USA?


What is the Expiration Date of your Visa?


AAMC Identification Number


Language native


Language fluencies






CURRENT ADDRESS

Address valid until (mm/dd/yyyy)


Street or PO Box


Street or PO Box


City


State


Zip code


Country


Phone day


Phone evening


Email address




PERMANENT ADDRESS

Contact Name


Street or PO Box


Street or PO Box


City


State


Zip code


Country


Phone day


Phone evening


Email address




PROSPECTIVE GS PROGRAM SELECTION

BR-Neuroscience


BU-Bioinformatics


GWU-Biomedical


GU-Biomedical Sciences


JHU-Cell, Molecular, Developmental Biology


NYU-Structural Biology


UMD-Biophysics


UMD-Hearing & Speech Sciences


UMT-Molecular Basis of Infectious Diseases


UNC-Cell Motility


UP-Immunology


OX-Biomedical Sciences


CAM-Health Sciences


KI-Neuroscience


NCI-Molecular Pathology


NINR-Nursing Research


NIH-MSTP


any additional programs



CURRENT GS PROGRAM SELECTION

Individual Agreement (IA)


Bulgaria Consortium (Bulgaria)


Hungary Consortium (Hungary)


KAIST Consortium (Korea)


Karolinska Institutet-Neuroscience (Sweden)


National Defense Medical Center (Twain)


Seoul National University-Biological Sciences (Korea)


Shanghai Second Medical University (China)


Tel Aviv University-Women's Health (Israel)


University of Cambridge-Health Sciences (England)


University of Naples Federico II (Italy)


University of Oxford-Biomedical Sciences (England)


University of Valparaiso-Neuroscience (Chile)


 …any additional programs

 


SCIENTIFIC DISCIPLINE INTERESTS

Choice one

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Choice two (optional)

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Choice three (optional)

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EDUCATION FIELDS
(REPEAT UP TO 6 TIMES) 

University name







Academic major







Academic minor/second major







Start date







Graduation date (actual/anticipated)







Grade Point Average







Grade Point Average Scale







Degree anticipated/awarded

Menu

Menu

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STANDARDIZED EXAMS - GRE

Date of exam


Verbal score


Quantitative score


Analytical score


Analytical written score



STANDARDIZED EXAM - GRE SUBJECT

Date of exam


Subject

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Subject score



STANDARDIZED EXAMS - MCAT

Date of exam


Verbal score


Physical science score


Biological science score


Writing sample score

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Total score




STANDARDIZED EXAMS - TOEFL

Date of exam


Type of exam (paper/computer)

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Listening score


Writing score


Reading score


Essay rating


Total score




NIH INFORMATION FOR DISSERTATION RESEARCH

NIH Sponsor / Mentor for Dissertation Research


NIH Administrative Officer


NIH Institute-Center


NIH Start Date as a PhD Graduate Student


NIH Address (Building / Room)


NIH Phone Number


NIH Training Duration



RECOMMENDATION LETTERS

Under the Privacy Act of 1974, you have the right to access to the information provided in the letters of recommendation unless you have waived such access. Please indicate your decision for each reference. Your choice will not affect your eligibility for admission.

REFERENCE – ONE

Greeting title


First name


Last name


Position title


Employment institution


Daytime phone


Email address


Waive letter access

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REFERENCE – TWO

Greeting title


First name


Last name


Position title


Employment institution


Daytime phone


Email address


Waive letter access

Menu


REFERENCE – THREE

Greeting title


First name


Last name


Position title


Employment institution


Daytime phone


Email address


Waive letter access

Menu



RESUME COMPONENTS

Research experience


Publications


Presentations


Awards/honors


Extracurricular activities


Personal statement/research proposal


Cover Letter


Additional Information




OPTIONAL STATISTICS

Ethnicity

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Race

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Gender

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Marital Status

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Disability

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How did you learn about the GPP?

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TRAVEL INFORMATION – COMPLETED BY APPLICANT


Travel Form
OMB Number: 0925-0501
Expiration Date: XXXXX XX, XXXX (Expiration Date Is Not the Application Deadline.)

  • Privacy Statement

  • Respondent Burden


Welcome to the NIH Graduate Partnerships Program on-line form for travel reservations. Please take a moment to complete the following fields to the best of your ability. A GPP staff member or Travel Agent will contact you to confirm your transportation and lodging reservations for your interviews.


After depressing the submit button a new webpage indicating successful submission of your travel information will be displayed. Uploading may take a few moments, please be patient. Contact the GPP if you have any questions or concerns.


Graduate Partnerships Program

National Institutes of Health

2 Center Drive: Building 2 / Room 2E06

Bethesda, Maryland 20892-0234

Phone: 301-594-9605

Fax: 301-594-9606

Email: [email protected]

Web: http://gpp.nih.gov


Best regards,

Graduate Partnerships Program


Name on Government ID


Address (Valid for Next 60-Days)



Street



City



State



Zip-Code



Country



Email



Phone


NIH-University Partnership


Interview Date(s) at NIH


NIH Campus Location?


Lodging Needed? Nights?


Interview Date(s) at University


University Location?


Lodging Needed? Nights?


Gender (To Arrange Lodging Reservations)


Valid & Active NIH Badge? NIH Trainee?


Travel – Point of Origin to NIH

Location, Airport, Departure Date, Time

Travel – NIH to University

Location, Airport, Departure Date, Time

Travel – University to Point of Origin

Location, Airport, Departure Date, Time

Additional Information




LETTER OF RECOMMENDATION – COMPLETED BY REFERENCE


Recommendation Letter
OMB Number: 0925-0501
Expiration Date: XXXXX XX, XXXX (Expiration Date Is Not the Application Deadline.)

Welcome to the NIH Graduate Partnerships Program on-line letter of recommendation submission website. Your letter of recommendation is very important in our selection process. We would particularly appreciate your comments on the student's overall intelligence, analytical ability, research ability, verbal and writing skills, interpersonal skills, motivation, and maturity. Your overall analysis of their potential to excel in graduate school and as a future scientist would be especially helpful.

After depressing the submit button a new webpage indicating successful submission of your recommendation will be displayed. Uploading the evaluation form and recommendation letter may take a few moments, please be patient. Contact the GPP if you have any questions or concerns.

Graduate Partnerships Program
National Institutes of Health
2 Center Drive: Building 2 / Room 2E06
Bethesda, Maryland 20892-0234

Phone: 301-594-9605
Fax: 301-594-9606
Email: [email protected]
Web: http://gpp.nih.gov

Thank you for submitting your evaluation.

Best regards,

Graduate Partnerships Program



APPLICANT’S INFORMATION

First Name

 

Last Name

 

Application Number

 

REFERENCE INFORMATION

Greeting Title

 

First Name

 

Last Name

 

Position Title

 

Employment Institution

 

Address

 

Address

 

City

 

State

 

Zip-code

 

Country

 

Daytime Phone Number

 

Fax Number

 

Email Address

 

APPLICANT'S EVALUATION

How long have you known the applicant?


In what capacity have you known the Applicant?


Intelligence

menu

Analytical Ability

menu

Research Ability

menu

Verbal Ability

menu

Writing Ability

menu

Interpersonal Skills

menu

Motivation for Research

menu

Confidence

menu

Initiative

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Honesty

menu

Knowledge of Field

menu

Maturity

menu

Overall Potential as a Scientist

menu

Letter of Recommendation



<Email Message>


LETTER TO APPLICANT – ANONYMOUS RESPONSE


Dear <First-Name>,

Thank you very much for taking the time to consider the NIH Graduate Partnerships Program for your Ph.D. education. Although you did not choose to enter our program we are glad you were able to find a graduate school that met your needs. Please keep NIH in mind when it comes time for your postdoctoral research training! We strongly believe we can provide outstanding research training for post-docs as well as graduate students.


We know your time is valuable, but would appreciate just a few minutes of your time to give us feedback on your experiences during the application and interview process, and your assessment of NIH as a potential site for graduate training. Your ideas are very important to us as we strive to make our application and programs as user-friendly and effective as possible. Your responses will be kept confidential and will have no effect on your participation in other NIH training programs.


Question: Is there any way in which we could have made the application, interview and selection processes easier or better for you?


Question: What two or three attributes or possibilities did you find most attractive about the Graduate Partnerships Program(s) to which you applied?


Question: What were the deciding factors in your choice not to do your PhD through the Graduate Partnerships Program?


Question: What PhD program did you choose and what were the most important positive deciding factors for your choice?


All the best to you,


Pat Wagner Ph.D.,

Director of Admissions & Registrar

Graduate Partnerships Program

National Institutes of Health

2 Center Drive: Building 2 / 2E12

Bethesda, Maryland 20892-0234

Phone: 301-594-9605

Fax: 301-594-9606

Email: [email protected]

Web: http://gpp.nih.gov


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File Typeapplication/msword
File TitleGraduate Partnerships Program
AuthorM J Wagner
Last Modified Bycurriem
File Modified2007-10-23
File Created2007-10-23

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