Form 92 Biosketch

Attachment E02 – NCI/DCTD/CTEP Biosketch

OMB #xxxx-xxxx
Expiration Date: xx/xx/xxxx

Public reporting burden for this collection of information is estimated to be 120 minutes per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (OMB #xxxx-xxxx). Do not return the completed form to this address.

Screenshots

Figure 7: NCI Biosketch – Electronic Capture of Personal Information

Figure 8: NCI Biosketch - Electronic Capture of Education

Figure 9: NCI Biosketch - Electronic Capture of Professional Training

Figure 10: NCI Biosketch - Electronic Capture of Employment

Figure 11: NCI Biosketch - Electronic Capture of Professional Certifications

Figure 12: NCI Biosketch - Electronic Capture of Professional Licenses

Figure 13: NCI Biosketch - Electronic Capture of ABMS Board Certification

Figure 14: NCI Biosketch - Electronic Capture of NCI Required Training

Breakdown of Elements
There are 14 different sections of the Biosketch that are electronically captured, with the
following information displayed for each section; the asterisk (*) indicates that the
section is mandatory for investigators to fill out:
1. Personal Information*
a. CTEP Person ID: A read-only display of the investigator’s CTEP Person
ID preceded by their registration type.
b. Prefix
c. First Name*
d. Middle Name or Initial
e. Last Name*
f. Suffix
g. Date of Birth
h. Signature Display*
i. Correspondence Display*
2. Education*
a. Add New Record: Allows the investigator to manually add education
information to their Biosketch.
b. Delete: Allows the investigator to delete a row of education information
from their Biosketch.
c. Country*: The country where the degree was conferred.
d. Degree*: The type of degree, e.g., B.S. or M.D.
e. Field of Study: The field of study/major the degree is concentrated in.
f. Institution*: The institution the degree was conferred from.
g. Location*: The location of the institution.
h. Completion Year*: The year the degree was conferred.
3. Professional Training*
a. Add New Record: Allows the investigator to manually add training to their
Biosketch.
b. Actions: Allows the investigator to delete a row of training information from
their Biosketch.
c. Country*: The country where the training was received.
d. From Year*: The year the training started.
e. To Year*: The year the training ended.
f. Position*: The position type of the training, e.g., residency or fellowship.
g. Institution*: The institution where the training was conducted.
h. Location*: The location of the institution.
4. Employment*
a. Add New Record: Allows the investigator to manually add employment to
their Biosketch.
b. Delete: Allows the investigator to delete employment information from their
Biosketch.
c. Country*: The country where the employment was held.
d. From Year*: The year the employment started.

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e. To Year*: The year the employment ended.
f. Position*: The position type of employment, e.g., physician.
g. Institution*: The institution where employment was held.
h. Location*: The location of the institution.
Professional Certification*
a. Add New Record: Allows the investigator to manually add certifications to
their Biosketch.
b. Delete: Allows the investigator to delete certification information from their
Biosketch.
c. Country*: The country where the certification was awarded.
d. Certification Title*: The official title of the certification.
e. Certification Provider*: The company or organization that held the
certification course.
f. Effective Date*: The date the certification became effective.
g. Expiration Date*: The date the certification expires.
Professional License*
a. Add New Record: Allows the investigator to manually add licenses to their
Biosketch.
b. Delete: Allows the investigator to delete license information from their
Biosketch.
c. Country*: The country where the license was granted.
d. License Type*: The type of license that was granted.
e. State/Province*: The state or province that granted the license.
f. License Number*: The number of the license.
g. Expiration Date*: The date the license expires.
ABMS Board Certification*
a. Add New Record: Allows the investigator to manually add board
certifications to their Biosketch.
b. Delete: Allows the investigator to delete board certification information
from their Biosketch.
c. Specialty*: The specialty of the ABMS certification.
d. Subspecialty: The sub-specialty of the ABMS certification, if applicable.
e. Board Eligible/Certified*: The status of the ABMS certification.
f. Effective Date*: The date the board certification is effective.
g. Expiration Date*: The date the board certification expires.
NCI Required Training*
a. Actions: Allows the investigator to edit or update NCI required training
information from their Biosketch.
b. Country*: The country where the NCI training was held.
c. Course Type*: The type of NCI training, e.g., GCP (Good Clinical
Practices) or HSP (Human Subject Protection).
d. Course Title*: The name of the course.
e. Training Provider*: The company or organization that provided the NCI
training.
f. Completion Date*: The date the NCI training was completed.
g. Expiration Date*: The date the NCI training expires.

h. Upload Certificate: Allows the investigator to upload a copy of the training
certificate.
9. CV: The Investigator can optionally upload a scanned version of their CV by
clicking the ‘Select files’ button and uploading the necessary file(s).
10. Personal Statement: The Investigator can enter a brief, optional description of
their suitability to take on a project role.
11. Professional Memberships
a. Add New Record: Allows the investigator to manually add memberships to
their Biosketch.
b. Delete: Allows the investigator to delete a membership from their
Biosketch.
c. Membership: The type of membership held.
d. From Year: The year the membership started.
e. To Year: The year the membership ended.
12. Honors
a. Add New Record: Allows the investigator to add honors to their Biosketch.
b. Delete: Allows the investigator to delete or update an honor from their
Biosketch.
c. Honor: The type of honor that was received.
d. From Year: Start year the honor was received.
e. To Year: End year the honor was received.
13. Publications – There are two sub-sections for Publications: 1) Publication(s)
Relevant to Current Application, and 2) Additional Publications. Both subsections have the following information:
a. Add New Record: Allows the investigator to add relevant publications to
their Biosketch.
b. Delete: Allows the investigator to delete or update a publication from their
Biosketch.
c. Year: The year the publication was published.
d. Citation: The citation information for the publication.
14. Research Support
a. Add New Record: Allows the investigator to add relevant studies to their
Biosketch.
b. Delete: Allows the investigator to delete or update a study from their
Biosketch.
c. Type: The type of research conducted.
d. Research ID: The research ID.
e. Principal Investigator: The name of the Principal Investigator.
f. From Date: The start date of the study.
g. To Date: The end date of the study.
h. Research Name: The title of the study.
i. Description: The description of the study.
j. Role: The investigator’s role in the study.