eRA commons A7 -new

A7 -new. eRA Commons Profile Data Elements.xls

Research and Research Training Grant Applications and Related Forms

eRA commons A7 -new

OMB: 0925-0001

Document [xlsx]
Download: xlsx | pdf

Overview

Person Profile
Degree LOV


Sheet 1: Person Profile

Attachment 7 - eRA Commons Person Profile Data









Currently Collected on OMB Cleard Forms









OMB Clearance # 0925-0001









Field Name Req
Opt
Type of Field LOV

















Personal Information




















Name Prefix O Text







First Name R Text







Middle Name O Text







Last Name R Text







Name Suffix O Text







SSN (full or last 4) O Text







Gender R LOV DNWTP
Female
Male







DOB
(Include DNWTP option)
R Date







Citizenship O LOV US Citizen or Non-citizen National
Permanent Resident
Non Resident







Citizenship Country O LOV Country List

















Disability









Do you have? O Y/N







Type of Disability O Checkboxes Hearing
Visual
Mobility/Orthopedic Impairment
Other


















Race/Ethnicity









Race R Checkboxes American Indian or Alaska Native
Asian
Black or African American
White
Native Hawaiian or Pacific Islander
DNWTP







Ethnicity R LOV Hispanic/Latino
Intentionally Withheld
Non-Hispanic


















Employments









Employer: Select one: R








NIH Recognized Institution
Text







NIH Institute or Center
LOV NIH ICs

















Employment Info









Start Date R Date







End Date O Date







Title O Text







Employment Status R LOV Full-Time
Part-Time







Academic Rank O LOV Assistant Professor
Associate Professor
Instructor
Other
Professor







Position O LOV Assistant or Associate Dean
Chairperson of Dept (or Director)
Dean
Other
President
Vice President







Employment Type R LOV Federal
Non-Federal







Primary Employment? N Checkbox


















Employment Address









Line 1 R Text







Line 2 O Text







Line 3 O Text







Line 4 O Text







City R Text







State R Text







ZipCode R Text







Country R LOV Country List






Phone R Text







Fax O Text







E-mail R Text







Preferred Employment Address?
Checkbox


















Reviewer Address









Line 1 R Text







Line 2 O Text







Line 3 O Text







Line 4 O Text







City R Text







State R Text







ZipCode R Text







Country R LOV Country List






Phone R Text







Fax O Text







E-mail R Text


















Residential Address









Line 1 R Text







Line 2 O Text







Line 3 O Text







Line 4 O Text







City R Text







State R Text







ZipCode R Text







Country R LOV Country List






Phone R Text







Fax O Text







E-mail R Text


















Degrees









Degree Name R LOV See separate Tab for LOV






Degree Text (for Other) O Text







Degree Completed? R Radio Buttons Yes
No/Inprogress







Major O Text







Minor O Text







Institution R Text







Location (if not in US, indicate city & country) O Text







Date (or expected Date) of Degree R Date







Length of Program (# of Yrs) O Text







Area of Residency
(Adding 1/2009)
O Text







Residency End Date
(Adding 1/2009)
O Date


















Publications









Citation ID O Text







Citation Text R Text


















Reference Ltrs









Referee Name









Grant Number









FOA Number









Project Title









Organziation/Affliation









Department









eMail









Submitted Date




















Trainee-Specific









Non-Deliquency on US Federal Debt? R Radio Buttons Yes
No







Text Entry field if Yes
Text


















Disadvantaged Background? R LOV Yes
No
DNWTP





























System Generated Fields
Adding 1/2009










Fields being added to aid in NI/ESI efforts. All will be system-generated but part of the Person Profile




















ESI Eligibility
Yes/No







End of Eligibility Date
Date







New Investigator Eligibility
Yes/No







Appeal Date
Date







Appeal Outcome
Text







Standard NI/ESI Eligibility will be system calculated. However an exception policy will be implemented. These exceptions will be handled via an appeal process.








Sheet 2: Degree LOV

Degrees LOV in Person Profile


AB   BACHELOR OF ARTS
BA   BACHELOR OF ARTS
BS   BACHELOR OF SCIENCE
DDS  DOCTOR OF DENTAL SURGERY
DMD  DOCTOR OF MEDICAL DENTISTRY
DPH  DOCTOR OF PUBLIC HEALTH
DSC  DOCTOR OF SCIENCE
DVM  DOCTOR OF VETERINARY MEDICINE
EDD  DOCTOR  OF EDUCATION
MA   MASTER OF ARTS
MBBS FOREIGN - BACHELOR OF MEDICINE AND SURGERY
MD   DOCTOR OF MEDICINE
MPH  MASTER OF PUBLIC HEALTH
MS   MASTER OF SCIENCE
PHD  DOCTOR OF PHILOSOPHY
RN   REGISTERED NURSE
SCD  DOCTOR OF SCIENCE
VMD  DOCTOR OF VETERINARY MEDICINE
OTH  OTHER
DRPH DOCTOR OF PUBLIC HEALTH
BSN  BACHELOR OF SCIENCE IN NURSING
DC   DOCTOR OF CHIROPRACTIC
DNSC DOCTOR OF NURSING SCIENCE
DO   DOCTOR OF OSTEOPATHY
FAAN FELLOW  OF THE AMERICAN ACADEMY OF NURSING
JD   DOCTOR OF JURIS PRUDENCE
MB   FOREIGN - BACHELOR OF MEDICINE
MBA  MASTER OF BUSINESS ADMINISTRATION
MLS  MASTER OF LIBRARY SCIENCE
MPA  MASTER OF PUBLIC ADMINISTRATION
MSN  MASTER OF  SCIENCE IN NURSING
OD   DOCTOR OF OPTOMETRY
BOTH OTHER BACCALAUREATE
MOTH OTHER MASTERS
DOTH OTHER DOCTORATE
MDOT OTHER DOCTOR OF MEDICINE
VDOT OTHER DOCTOR OF VETERINARY MEDICINE
DDOT OTHER DOCTOR OF MEDICAL DENTISTRY
ENGD FOREIGN - DOCTOR OF ENGINEERING
PHMD DOCTOR OF PHARMACY
ND   DOCTOR OF NATUROPATHY
DSW  DOCTOR OF SOCIAL WORK
PSYD DOCTOR OF PSYCHOLOGY
DPM  DOCTOR OF PODIATRIC MEDICINE
File Typeapplication/vnd.ms-excel
Authorhahnm
Last Modified Bycurriem
File Modified2009-03-03
File Created2008-10-30

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