Form 34 MyOITE-Alumni

CREATE AN NIH ALUMNI DATABASE ENTRY

OMB Number: 0925-0299
Expiration Date: 30-June-2022
Thank you for taking the time to create an entry for yourself in the NIH Alumni Database. This is a new
venture for the NIH Office of Intramural Training & Education (OITE) and we have big plans.
You may be wondering why you should take the time to complete the brief form below today and keep
your entry up to date in the future. Here are several reasons:
First, what's in it for YOU? Networking! You will be helping to create a searchable database of potential
colleagues that you can mine to meet your own needs and those of your students and friends. But, in
addition
The OITE invites former NIH trainees to speak at events like the Career Symposium and the National
Graduate Student Research Festival. The success of those ventures depends on our keeping in contact
with a diverse group of NIH alumni that could include you.
Applicants to NIH training programs often want to know where program participants go next.  Where do
NIH postbacs go to graduate or professional school?  Where do NIH postdocs find jobs?  You can help us
provide those data.
If you wish, you can become part of a worldwide network of NIH alumni who are willing to answer current
trainees' questions about schools and jobs.
Database Rules:

Information that you enter into the database will be made public e.g., in publications describing NIH
programs, only in the aggregate; no personally identifiable information will be published outside of this
system.
Your personally identifiable information (see below) will be included in the searchable database only if
you authorize the OITE to include it.  You can change your mind at any time.
Only Alumni Database account-holders, current NIH trainees, and NIH staff will be able to search the
Database.
You can update your educational and/or employment history and preferences at any time.
CONTACT INFORMATION
Honorary Title:
First Name (Given Name)*:
Last Name (Family Name)*:
State:
Country:

Permanent E-mail (nonNIH)*:
Permanent E-mail (nonNIH) - Confirm*:

e.g., gmail, hotmail

Password*:
Verify Password*:
What is your current
status?*:

EDUCATION HISTORY

Please tell us about your education. List your highest or most recent degree first. Please also complete this
section if you have been accepted to and plan to enter a degree program.
Degree(s) Awarded*:

(select all that apply)
AUD
MPH
MS
MD/PhD
DDS
DVM
Other

BA/BS
NP
PhD/DPhil
DO
DDS/PhD
MBA

DPH
RN
MD
PharmD
DMD
JD

If other, indicate which
degree?:
School Name*:
Academic Major:
School City*:
School State*:
School Country:
Education Start Date:
Education End Date:
Current Institution:

I am currently enrolled at this institution 

Do you have more education history you would like to add? If
so, click the education information button below.

Delete
Add Education Information
NIH TRAINING INFORMATION

Please tell us about any time you have spent at the NIH. List your most recent experiences first and lists all
experiences in reverse chronological order.
Tell us about your NIH
training experiences,

what was the last
position that you held at
NIH?*:
Institute-Center*:
Investigatorʼs Name:
NIH Start Date*:
NIH End Date*:

Do you have more NIH training history you would like to add? If
so, click the NIH information button below.

Add NIH Information
Member of Trainee
Committee:

(select all that apply)
FelCom (The NIH Fellows Committee)
The GSC (Graduate Student Council)
The Postbac Committee

NEXT STEP
What is your next step?:

EMPLOYMENT

If you have accepted a postdoc or job offer, or are currently employed, please complete this section. If you
have held multiple positions, please list them in reverse chronological order.
Employment –
Organization*:
Employment –
Department:
Employment – City*:
Employment – State*:
Employment – Country:
Current Institution:
Employment – Start Date*:
Employment – Stop Date*:
What type of employment
sector are you in?:
What type of position are
you in?:
What are you doing in
your position?:

I am currently employed by this institution 

Do you have more employment history you would like to add? If
so, click the employment information button below.

Delete
Add Employment Information
NETWORKING OPPORTUNITIES
Networking Contact*:

Are you willing to serve as a networking contact for NIH trainees?
We anticipate that they might seek your advice on career
planning, the graduate/professional school application process,
the job search process, or your particular position.
Note: By clicking yes, you are authorizing OITE to include you in
the searchable database. By clicking no, you will not be included
in any search results provided to the public.
Yes
No

Career Counselor Contact*:

Would you be willing to be a contact for career counselors in the
Office of Intramural Training & Education at the NIH or OITE staff
organizing training events?
Yes
No

Create Account

Cancel

Collection of this information is authorized by The Public Health Service Act, Section 410 (42 USC 285).Rights
of participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are nopenalties
for not participating or withdrawing from the study at any time. The information collected in thisstudy will be
kept private to the extent provided by law. Names and other identifiers will not appear in anyreport of the
study. Information provided will be combined for all participants and reported as summaries
Public reporting burden for this collection of information is estimated to average 15 minutes per
response,including the time for reviewing instructions, searching existing data sources, gathering and
maintaining thedata needed, and completing and reviewing the collection of information. An agency may not
conduct orsponsor, and a person is not required to respond to, a collection of information unless it displays
a currentlyvalid OMB control number. Send comments regarding this burden estimate or any other aspect of
thiscollection of information, including suggestions for reducing this burden, to: NIH, Project Clearance
Branch,6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0299). Do not
return thecompleted form to this address.