Form 10 UGSP Evaluation Scholar Payback Period

NIH Office of Intramural Training & Education Application (OD)

Form10-UGSP-EvaluationScholarPaybackPeriod

Undergraduate Scholarship Program Evaluation of Scholar PayBack Period

OMB: 0925-0299

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UNDERGRADUATE SCHOLARSHIP PROGRAM - EVALUATION FOR PAY-BACK
OMB No. 0925-0299
Expiration Date 8/31/2016
Respondent Burden

Please provide your assessment of the UGSP scholar's performance in your laboratory.

UGSP SCHOLAR INFORMATION
UGSP Scholar First Name

UGSP Scholar Last Name

Type of Service
Summer Service

Pay-Back Year

Scholar's Period of Service - Start Date
August

08

2015

Scholar's Period of Service - Stop Date
August

08

2015

EVALUATION OF SCHOLAR
Interest in Science
Top 1%

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Ability to Complete Projects Accurately and Timely
Top 1%

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Writing Skills
Top 1%

Analytical Problem-Solving Skills

Top 1%

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 50%

Bottom 50%

N/A

Top 33%

Top 50%

Bottom 50%

N/A

Top 33%

Top 50%

Bottom 50%

N/A

Oral Communication Skills
Top 1%

Top 10%

Top 33%

Ability to Work Independently
Top 1%

Top 10%

Rapport with Peers
Top 1%

Top 10%

Rapport with Faculty or Supervisor
Top 1%

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 10%

Top 33%

Top 50%

Bottom 50%

N/A

Top 33%

Top 50%

Bottom 50%

N/A

Initiative
Top 1%
Curiosity
Top 1%
Creativity
Top 1%

Observation Skills
Top 1%

Top 10%

Please assess the scholar's potential for a career in biomedical research and share
any observations and inferences that would be useful in predicting this scholar's
potential to become a biomedical, behavioral, and social science health-related
researcher. For example, your comments may include your assessment of some of the
following attributes: scientific aptitude, creativity, curiosity, initiative, work habits,
and peer relationships.
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Do you have any reason to believe that the scholar may not satisfy the postgraduation service requirement?
The UGSP scholars are required to fulfill two service obligations for each year of scholarship
support: (1) one obligation has been satisfied this summer; (2) the second obligation is
upon graduation (unless a deferment is granted), when scholars incur 1 year of research
training in intramural labs for each full year of scholarship support.

Yes

No

If you feel this UGSP scholar will not satisfy the post-graduation service
requirement, please explain.
This text box can scroll to accommodate lengthy answers.

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