| Attachment 12 - 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 |
| eRA Email | R | Text | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| Is this your Terminal Research Degree? | O | Checkbox | |
| 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 | |||
| 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 | |||
| Fields used to aid in NI/ESI efforts. All are 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 is system calculated. However an exception policy has been implemented. These exceptions are handled via an appeal process. | |||
| 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 Type | application/vnd.ms-excel |
| Author | hahnm |
| Last Modified By | CTAC |
| File Modified | 2012-06-30 |
| File Created | 2008-10-30 |