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pdfNAME OF APPLICANT (Last, first, middle initial)
Kirschstein−NRSA Individual Fellowship Application
(To be completed by applicant – follow PHS 416-1 instructions)
SPONSOR and Co-Sponsor Information
15. NAME OF SPONSOR
16. NAME OF Co-SPONSOR (When applicable)
15a. NAME AND DEGREE(S)
16a. NAME AND DEGREE(S)
15b. ERA COMMONS USER NAME
16b. ERA COMMONS USER NAME
15c. DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT
16c. DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT
15d. MAJOR SUBDIVISION
16d. MAJOR SUBDIVISION
15e. Address:
16e. Address:
Telephone:
Telephone:
Fax:
Fax:
E-Mail:
E-Mail:
RESEARCH PROPOSAL
17. DESCRIPTION: See instructions. State the application’s broad, long-term objectives and specific aims, making reference to the health
relatedness of the project (i.e., relevance to the mission of the agency). Describe concisely the research design and methods for achieving these
goals. Describe the rationale and techniques you will use to pursue these goals.
In addition, in two or three sentences, describe in plain, lay language the relevance of this research to public health. If the application is funded, this
description, as is, will become public information. Therefore, do not include proprietary/confidential information. DO NOT EXCEED THE SPACE
PROVIDED.
PHS 416-1 (Rev. 6/12)
Page
2
Number pages consecutively at the bottom throughout
the application. Do not use suffixes such as 2a, 2b.
Form Page 2
File Type | application/pdf |
File Title | PHS 416-1fp2 (Rev. 6/12), Form Page 2 |
Subject | Ruth L. Kirschstein National Research Service Award Individual Fellowship Application, PHS 416-1fp2 (Rev. 6/12), Form Page 2 |
Author | DHHS, Public Health Service |
File Modified | 2012-05-03 |
File Created | 2008-09-09 |