Document
eRA commons A7 -new
ICR 200903-0925-001 · OMB 0925-0001 · Object 10993701.
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| File Type | application/vnd.ms-excel |
|---|---|
| File Title | eRA commons A7 -new |
| Author | hahnm |
| Last Modified By | Calc |
| File Modified | 2009-03-03 |
| File Created | 2026-11-13 |
| Conversion State | complete |
Extracted Text
Attachment 7 - eRA Commons Person Profile Data Currently Collected on OMB Cleard Forms OMB Clearance # 0925-0001 Field Name Req Opt Type of Field O R O R O O Text Text Text Text Text Text LOV Personal Information Name Prefix First Name Middle Name Last Name Name Suffix SSN (full or last 4) Gender R LOV DOB (Include DNWTP option) R Date DNWTP Female Male US Citizen or Non-citizen National Permanent Resident Non Resident Country List Citizenship Citizenship Country O O LOV LOV Disability Do you have? O Y/N O Hearing Visual Mobility/Orthopedic Impairment CheckboxeOther R American Indian or Alaska Native Asian Black or African American White Native Hawaiian or Pacific Islander CheckboxeDNWTP Type of Disability Race/Ethnicity Race Ethnicity Employments Employer: Select one: NIH Recognized Institution NIH Institute or Center R LOV Hispanic/Latino Intentionally Withheld Non-Hispanic R Text LOV NIH ICs 1 of 5 11/13/2026 Attachment 7 - eRA Commons Person Profile Data Currently Collected on OMB Cleard Forms OMB Clearance # 0925-0001 Field Name Employment Info Start Date End Date Title Employment Status Academic Rank Req Opt Type of Field R O O Date Date Text R LOV Full-Time Part-Time LOV Assistant Professor Associate Professor Instructor Other Professor O Position O LOV Employment Type Primary Employment? R LOV N Checkbox Employment Address Line 1 R Line 2 O Line 3 O Line 4 O City R State R ZipCode R Country R Phone R Fax O E-mail R Text Text Text Text Text Text Text LOV Text Text Text Preferred Employment Address? Checkbox Reviewer Address Line 1 Line 2 Line 3 Line 4 City State ZipCode Country Phone Fax R O O O R R R R R O Text Text Text Text Text Text Text LOV Text Text LOV Assistant or Associate Dean Chairperson of Dept (or Director) Dean Other President Vice President Federal Non-Federal Country List Country List 2 of 5 11/13/2026 Attachment 7 - eRA Commons Person Profile Data Currently Collected on OMB Cleard Forms OMB Clearance # 0925-0001 Field Name E-mail Req Opt R Type of Field Text Residential Address Line 1 Line 2 Line 3 Line 4 City State ZipCode Country Phone Fax E-mail R O O O R R R R R O R Text Text Text Text Text Text Text LOV Text Text Text R LOV O Text R O O R Yes Radio Butt No/Inprogress Text Text Text Degrees Degree Name Degree Text (for Other) Degree Completed? Major Minor Institution Location (if not in US, indicate city & O country) Date (or expected Date) of Degree R Length of Program (# of Yrs) O Area of Residency O (Adding 1/2009) Residency End Date O (Adding 1/2009) Publications Citation ID Citation Text O R LOV Country List See separate Tab for LOV Text Date Text Text Date Text Text Reference Ltrs Referee Name Grant Number FOA Number Project Title Organziation/ Affliation Department eMail Submitted Date 3 of 5 11/13/2026 Attachment 7 - eRA Commons Person Profile Data Currently Collected on OMB Cleard Forms OMB Clearance # 0925-0001 Field Name Trainee-Specific Non-Deliquency on US Federal Debt? Req Opt Type of Field R Yes Radio Butt No Text Entry field if Yes Disadvantaged Background? LOV Text R LOV Yes No DNWTP 4 of 5 11/13/2026 Degrees LOV in Person Profile AB BA BS DDS DMD DPH DSC DVM EDD MA MBBS MD MPH MS PHD RN SCD VMD OTH DRPH BSN DC DNSC DO FAAN JD MB MBA MLS MPA MSN OD BOTH MOTH DOTH MDOT VDOT DDOT ENGD PHMD ND DSW PSYD DPM BACHELOR OF ARTS BACHELOR OF ARTS BACHELOR OF SCIENCE DOCTOR OF DENTAL SURGERY DOCTOR OF MEDICAL DENTISTRY DOCTOR OF PUBLIC HEALTH DOCTOR OF SCIENCE DOCTOR OF VETERINARY MEDICINE DOCTOR OF EDUCATION MASTER OF ARTS FOREIGN - BACHELOR OF MEDICINE AND SURGERY DOCTOR OF MEDICINE MASTER OF PUBLIC HEALTH MASTER OF SCIENCE DOCTOR OF PHILOSOPHY REGISTERED NURSE DOCTOR OF SCIENCE DOCTOR OF VETERINARY MEDICINE OTHER DOCTOR OF PUBLIC HEALTH BACHELOR OF SCIENCE IN NURSING DOCTOR OF CHIROPRACTIC DOCTOR OF NURSING SCIENCE DOCTOR OF OSTEOPATHY FELLOW OF THE AMERICAN ACADEMY OF NURSING DOCTOR OF JURIS PRUDENCE FOREIGN - BACHELOR OF MEDICINE MASTER OF BUSINESS ADMINISTRATION MASTER OF LIBRARY SCIENCE MASTER OF PUBLIC ADMINISTRATION MASTER OF SCIENCE IN NURSING DOCTOR OF OPTOMETRY OTHER BACCALAUREATE OTHER MASTERS OTHER DOCTORATE OTHER DOCTOR OF MEDICINE OTHER DOCTOR OF VETERINARY MEDICINE OTHER DOCTOR OF MEDICAL DENTISTRY FOREIGN - DOCTOR OF ENGINEERING DOCTOR OF PHARMACY DOCTOR OF NATUROPATHY DOCTOR OF SOCIAL WORK DOCTOR OF PSYCHOLOGY DOCTOR OF PODIATRIC MEDICINE