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 |