FMS Application Module Draft (track change)

Att 3_FMS Applic_07282023_tracked.docx

[PHIC] Fellowship Management System

FMS Application Module Draft (track change)

OMB: 0920-0765

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0765 can be found here:

2024-09-26 - No material or nonsubstantive change to a currently approved collection
2024-08-05 - No material or nonsubstantive change to a currently approved collection

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Form Approved

OMB No. 0920-0765

Shape2 Exp. Date 03/31/2026

Fellowship Management System (FMS)

Privacy Act and Public Burden Information

Privacy Act Information

The Privacy Act applies to this information collection. Information collected will be kept private as noted in the System of Records Notice is 09-20-0112, Fellowship Program and Guest Researcher Records.

Public Burden Information

Form Approved

OMB No. 0920-0765

Exp. Date 03/31/2023

Public reporting burden of this collection of information is an estimated average of 87 minutes per response, with an additional 15 minutes for the reference letter writers (total 102 min), and 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0765).

FMS Application Module Draft

Table of Contents 2

1. Introduction 3

1.1 Document Structure 4

2. Sign-In & Sign-Up Pages 5

2.1 Sign-In Page 5

2.2 Sign-Up Page (For New Users) 5

3. eFMS System Help Desk Ticket 5

4. Application Welcome Page 5

5. Applicant Profile 5

5.1 Create a Profile to Get Started 5

5.2 Applicant Name 5

5.3 Email Address 5

5.4 Phone Number 5

5.5 Mailing Address 5

5.6 Emergency Contact 5

6. Eligibility 5

6.1 Get Started 5

6.2 Citizenship Status 5

6.3 TOEFL Score 5

6.4 PMR/F 5

6.4.1 Eligibility 5

6.4.2 Commissioned Corps 5

6.4.3 Public Health Work Experience 5

6.5 PHIFP 5

6.5.1 Eligibility 5

6.6 SAF 5

6.6.1 Teaching Experience 5

6.7 EEP 5

6.7.1 Academic Endorsement 5

6.8 PHAP 5

6.8.1 Special Requirements 5

6.9 FLIGHT 5

6.9.1 Clinical Category & Training 5

6.9.2 Current EIS Position 5

6.9.3 Current Primary Supervisor 5

6.9.4 Scientific Experience 5

6.10 PH-TIPP 5

6.10.1 Eligibility 5

6.10.2 Program & Organization 5

6.10.3 Host Site Position Description 5

6.11 ELI 5

6.11.1 Organization Details 5

6.11.2 Educational Experience 5

6.11.3 Work Experience 5

6.11.4 e-Learning Content Example 5

6.12 EIS, LLS, FLIGHT, PE, PHIFP 5

6.12.1 Federal Student Loan Repayment Interest 5

6.13 Confirming Accuracy & Minimum Eligibility 5

7 Education & Licenses 5

7.1 Adding Education or Licenses 5

7.2 Choose Category 5

7.3 Coursework Type 5

7.4 Location 5

7.5 College/University 5

7.6 Status 5

7.7 Degree 5

7.8 Additional Coursework 5

7.9 License 5

7.10 Dates 5

7.11 Incomplete Reason 5

8 Work & Volunteer Experience 5

8.1 Adding Work or Volunteer Experience 5

8.2 Choose Category 5

8.3 Organization Details 5

8.4 Position Details 5

8.5 Dates 5

8.6 Position Location 5

9 Additional Training & Skills 5

9.1 Adding Additional Training & Skills 5

9.2 Choose Category 5

9.3 Clinical Training 5

9.4 U.S. Board Certifications and Specialty 5

9.5 Additional Training, Certifications, or Professional Development 5

9.6 Institution Details and Location 5

9.7 Dates 5

9.8 Language Skills 5

10 Publications, Presentations, Working Papers, Monographs or Reports, Grants, Honors and Awards 5

10.1 Adding Publications, Presentations, Working Papers, Monographs or Reports, Grants, Honors and Awards 5

10.2 Choose Category 5

10.3 Details 5

11 Personal Statement 5

11.1 All Fellowships except FLIGHT 5

11.2 FLIGHT 5

11.3 Location Preferences 5

11.4 CDC Fellowship Participation 5

12 Standardized Letters of Recommendation (SLOR) 5

12.1 SLOR Requests 5

12.1.a Starting a SLOR Request 5

12.2 System Emails to Letter Writers 5

12.3 Letters of Recommendation 5

12.3.1 Section A 5

12.3.2 Section B 5

12.3.3 Section C 5

13 Final Application Sections 5

13.1 Self-Assessment of Skills 5

13.1.1 PHIFP 5

13.1.2 PE 5

13.2 Applicant Survey 5

13.3.3 EEP Rotation Preferences & Topic/Subject Areas 5

13.3.1 Rotation Preferences 5

13.3.2 Topic & Subject Areas 5

13.3.3 Location Preferences 5

13.4 SAF Public Health Interests 5

13.5 EIS CIO Assignment Interests 5

13.6. Writing Samples 5

13.6.1 EIS Writing Samples 5

14 Match 5

14.1 Match or Prematch Rank/Rating Form 5

15 Selection Status Acceptance Form 5

16 EIS Conference Interview Time Selection Form 5

Appendix 5

I. Field Value Tables 5

II. Lookup Tables 5

Introduction

The purpose of this document is to list all the data elements collected online through the Fellowship Management System (FMS). The FMS online application module is a streamlined mechanism for applicants of the Centers for Disease Control and Prevention (CDC) fellowships to submit their information online and track statuses of the application processes (e.g., all required materials received, invited for interviews). The FMS is a robust flexible framework and the FMS Application Module is tailored successfully for various CDC fellowships:

Epidemic Intelligence Service (EIS)
CDC E-learning Institute (ELI)
Epidemiology Elective Program (EEP)
Future Leaders in Infections and Global Health Threats (FLIGHT)
Laboratory Leadership Service (LLS)
CDC Steven M. Teutsch Prevention Effectiveness (PE) Fellowship
Public Health Associate Program (PHAP)
Public Health Informatics Fellowship Program (PHIFP)
Science Ambassador Fellowship (SAF)
Evaluation Fellowship Program (EFP)

Document Structure

This document is broken down by the major pages of the FMS Application. In this document, each page of the FMS Application has sections and some sub-sections. In addition, application instructions, login, and registration pages are included. Instructions and emails in the FMS Application are tailored to each CDC fellowship’s requirements, eligibility criteria, information, and timeline.

Following the screenshots in each section is a table that shows the status of the collection of data elements by each CDC fellowships. The following labels indicate the status of the collection:

“Yes” indicates that the fellowship collects the information and that applicants are required to submit this information.
“No” indicates that the fellowship does not collect this information.
“Open Text Response” indicates an open-ended response prompt

In addition, the table shows the data values of each data element, and for ones that have a list of dropdown values, the data value category is hyperlinked to its list located in the Appendix.

Sign-In & Sign-Up Pages
- Sign-In Page

INSTRUCTIONAL TEXT:

Privacy Act Information

The Privacy Act applies to this information collection. Information collected will be kept private as noted in the System of Records Notice 09-20-0112, Fellowship Program and Guest Researcher Records

Public Burden Information

Form Approved

OMB No. 0920-0765

Exp Date 03/31/2023

Participation in this information collection is required for fellowship applicants and fellowship recipients. CDC uses information submitted through eFMS to select recipients, match recipients to opportunities, monitor progress, and improve the effectiveness of fellowship programs. CDC’s authority to collect this information is provided by the Public Health Service Act in §301, Title 42 U.S.C. §241(a)

Fellowship Application Module

Public reporting burden of this collection of information is estimated to average 75 minutes per response, including the 15 minutes for the reference of letter writers, and 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74 Atlanta, Georgia 30333; ATTN: PRA (0920-0765).

Table 2.1-a. Sign-In Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Email	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Password	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

Sign-Up Page (For New Users)

INSTRUCTIONAL TEXT:

Enter an email address and choose a password to create a new account.

Table 2.2-a. Sign-Up Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Email	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Password	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Confirm Password	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

eFMS System Help Desk Ticket

CDC ENTERPRISE FELLOWSHIP MANAGEMENT SYSTEM

System Help Desk Ticket

Please submit help desk tickets for system related (technical) issues or needs only. If you have a fellowship program related question or need, please contact the fellowship program directly.

Table 3-a. eFMS System Help Desk Ticket Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Your Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Sign-In Email:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Contact Phone Number (optional):	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Fellowship:	See Appendix p. 120	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
What type of issue or need do you have?	1. System Error Message 2. Sign-In or Password 3. Smart Card Sign-In 4. Data Not Saving 5. Unable to Submit 6. Reset application back to "Draft" 7. Withdraw Fellowship Application 8. Other	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
URL where the issue is occurring:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Error code message:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Please describe your issue or need:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Screenshot of error or issue (optional):	File Upload	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

Application Welcome Page

[Program] Fellowship Application Portal

Profile

Welcome to the [program] Fellowship Application Portal

Please contact the [program] program at [program]@cdc.gov

Privacy Act and Public Burden Information

Technical Support: For technical support to address a system issue, or to withdraw your application, please submit a System Help Desk Ticket

Letter writers having any issues should email the [program] program [program]@cdc.gov

Applicant Profile
- Create a Profile to Get Started

INSTRUCTIONAL TEXT:

Create a profile to get started

Applicant Name

Table 5.2-a. Applicant Name Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
First Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Middle Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Last Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Suffix:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Other Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Preferred Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	YesD

Email Address

Table 5.3-a. Email Address Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Primary Email Address: Note: Your primary email will be used to communicate with you throughout the application process. Make sure your primary email is typed in correctly. Do not use a college or university email as your primary email Instructional text for EFP: Please do not use a school or work email.	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
By checking this box, you confirm that the email address above is accurate:	1. I confirm that the email address above is accurate.	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Secondary/Alternate Email Address:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No

Phone Number

Table 5.4-a. Phone Number Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Phone Code:	See Appendix p. 120	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Primary Phone Number: Note: the primary phone number may be used to contact you during the application process. Make sure your primary phone number is typed in correctly.	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
By checking this box, you confirm that the phone number above is accurate:	1. I confirm that the phone number above is accurate.	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Secondary/Alternate Phone Number:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No

Mailing Address

Table 5.5-a. Mailing Address Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Mailing Address:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Mailing Address Line 2:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Mailing Address Line 3:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Country:	See Appendix p. 120	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
State/Territory:	See Appendix p. 120	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
State/Province:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
City:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Zip/Postal Code:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No

Emergency Contact

Table 5.6-a. Emergency Contact Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
EC Full Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
EC Relationship:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
EC Phone Number:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
EC Email:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No

Eligibility
- Get Started

Table 6.1-a. Get Started

INSTRUCTIONAL TEXT:

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Application and documents must be submitted by <date> 05:00pm (ET)

Yes

Complete all sections of the online application

-Each section must have at least 1 entry to successfully submit

-All supporting materials, including letters of recommendation, must be received by the deadline

-Please review the fellowship website for further instructions about supporting materials

-Re-applicants must click the "add another" button to create a new application. Re-submitting your old application will not count as a submission for this year.

Yes

Citizenship Status

Table 6.2-a. Citizenship Status Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Country of Birth:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
Country of Citizenship:	See Appendix p. 120	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
If Country of Citizenship is not the United States, then display text: “Please be aware that non-U.S. Citizens will not be able to travel internationally and will be limited to positions focused on domestic work."
Are you a U.S. permanent resident?	1. Yes 2. No	Yes	Yes	No	No	No	Yes	Yes	Yes	Yes	Yes
Do you currently live in the U.S.?	1. Yes 2. No	Yes	Yes	No	No	No	Yes	Yes	Yes	Yes	No
Visa Type:	1. F-1 2. H-1B 3. J-1 4. O-1 5. TN 6. Other	Yes	Yes	No	No	No	Yes	Yes	No	Yes	Yes
Specify Visa Type:		Yes	Yes	No	No	No	Yes	Yes	No	Yes	Yes
Visa Expiration Date:		Yes	Yes	No	No	No	Yes	Yes	No	Yes	Yes
Please upload a copy of your green card with expiration date past end of two-year Fellowship (if applicable) Applicants must be U.S. citizens or permanent residents with green cards. The green card must be valid for at least two more years from the start of the Fellowship (mid-Aug).	File Upload Field	No	No	No	No	No	No	No	No	No	Yes
Do you have a completed degree from the approved TOEFL exempt countries list?	1. Yes 2. No	Yes	Yes	No	No	No	Yes	No	No	No	No
Which country is your degree from?	Approved Country List	Yes	Yes	No	No	No	Yes	No	No	No	Yes
Please Upload CV	File Upload Field	No	No	No	No	No	No	Yes	No	No	Yes
Do you have or are you in the process of completing a PhD degree?	Yes No	No	No	No	No	No	No	Yes	No	No	No

TOEFL Score

Table 6.3-a. TOEFL Score Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
New Instructional Text: Test of English as a Foreign Language (TOEFL) for Non-U.S. Citizens and Non-U.S. Permanent Residents: • Non-U.S Citizens and Non-U.S. Permanent Residents must demonstrate their English Proficiency either by: o Indicating they were born in a country in which English is the native Language and that English is their native language, or o Providing TOEFL scores equal to 100 or higher on the internet-based TOEFL, 250 on the computer-based TOEFL, or 600 on the paper-based TOEFL • For more information about the TOEFL Requirements please click here • Please contact the PHIFP program via email at [email protected] if you have any additional questions.							Yes				No
TOEFL Test Type:	1. Internet-Based Test 2. Computer-Based Test 3. Paper-Based Test	Yes	No	No	No	No	Yes	No	No	No	No
TOEFL Score:	-	Yes	No	No	No	No	Yes	No	No	No	No
TOEFL Score Upload:	File Upload field-	Yes	No	No	No	No	Yes	No	No	No	No

PHIFP
- Eligibility

Table 6.5.1-a. PHIFP - Eligibility Fields

INSTRUCTIONAL TEXT:

Do you have doctoral (PhD, MD, PharmD) or masters level experience from an accredited academic institute in one of the following

Public health informatics
General Informatics or related field
Data Science and computer science
Information technology
Statistics and epidemiology
Medicine
Healthcare research and practice

New Instructional Text: Instructions: Please review the PHIFP website (https://www.cdc.gov/phifp/application/eligibility.html) for eligibility criteria for master-level vs. doctoral-level applications. PHIFP requires 3 years of experience in Public Health Informatics and Public Health for Master-level (e.g., MPH, MSc) applicants; however, that is not required for doctoral-level applicants (e.g., PhD, MD). All applicants need to demonstrate research/evaluation experience, and your academic degree has to be from an accredited academic institution.

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Degree level selection:	1. Doctoral 2. Masters 3. None	No	No	No	No	No	Yes	No	No	No	No
How many years of experience do you have in public health or related field?	Numeric response						Yes				No
How many years of experience do you have in informatics and/or data science?	Numeric Response						Yes				No
Informatics experience selection: (1 Year)	1. Yes 2. No	No	No	No	No	No	Yes	No	No	No	No
Public health experience selection: (1 Year)	1. Yes 2. No	No	No	No	No	No	Yes	No	No	No	No
Informatics experience selection: (3 Years)	1. Yes 2. No	No	No	No	No	No	Yes	No	No	No	No
Public health experience selection: (3 Years)	1. Yes 2. No	No	No	No	No	No	Yes	No	No	No	No
Do you have documented experience in performing research or evaluation during or after academic training? This includes publications, thesis, poster presentations, or a research or evaluation proposal.	1. Yes 2. No	No	No	No	No	No	Yes	No	No	No	No
Please Specify: (note to admin: field used when previous question is “YES”)	Open text response						Yes				No

INSTRUCTIONAL TEXT:

You are eligible to apply to the CDC Public Health Informatics Fellowship Program

You are not eligible at this time to apply to the CDC Public Health Informatics Fellowship Program. Please review the eligibility requirements on the PHIFP website. If you feel this is an error, you can email the program at [email protected]

SAF
- Teaching Experience

Table 6.6.1-a. Teaching Experience Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Grade Levels Ever Taught (select all that apply):	1. Elementary School (grades K-5) 2. Middle School (grades 6-8) 3. High School (grades 9-12) 2. Community College 3. College (Undergraduate) 4. College (Graduate) 5. Other: Curriculum Development 6. Other: Professional Development 7. Other (Specify)	No	No	No	No	Yes	No	No	No	No	No
Specify Current Grade Level(s) Taught (select all that apply):	1. Elementary School (grades K-5) 2. Middle School (grades 6-8) 3. High School (grades 9-12) 2. Community College 3. College (Undergraduate) 4. College (Graduate) 5. Other: Curriculum Development 6. Other: Professional Development 7. Other (Specify)	No	No	No	No	Yes	No	No	No	No	No
Specify Grade Level Taught:	Open text response	No	No	No	No	Yes	No	No	No	No	No
In the past 5 years, in which ways have you interacted with the Science Ambassador program? (Select all that apply)	Attended a CDC Science Ambassador regional training workshop Previously applied to the CDC Science Ambassador Fellowship Used CDC NERD Academy curriculum in my classroom Used CDC Science Ambassador lesson plans in my classroom None of the above Other	No	No	No	No	Yes	No	No	No	No	No

EEP
- Academic Endorsement

Table 6.7.1-a. Academic Endorsement Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Academic Endorsement Form:	Upload File	No	No	No	Yes	No	No	No	No	No	No

PHAP
- Special Requirements

Table 6.8.1-a. Special Requirements Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
What is the highest degree you will have attained by the start of the program?	1. Bachelor’s degree 2. Master’s degree 3. Doctorate 4. Other	No	No	No	No	No	No	No	No	Yes	No
Please specify:	Open text response	No	No	No	No	No	No	No	No	Yes	No
Actual or anticipated date of attained degree:	Open text response	No	No	No	No	No	No	No	No	Yes	No
What is/was your overall GPA on a 4.0 scale for your highest degree attained by the start of the program?	Open text response	No	No	No	No	No	No	No	No	Yes	No
Do you have a preference in location where you are willing to relocate? Please note that your preference of location does not affect your rating or eligibility into the program. The information, when possible, is used for matching purposes only. There are no assignments at CDC headquarters in Atlanta, Georgia. Most importantly, while geographic preference may be taken into consideration, assignment offers in selected areas are not guaranteed and are non-negotiable. If you answered yes, please rank up to 5 locations where you are willing to relocate for this program (1-5 highest to lowest preference). Please note that PHAP does not pay for relocation expenses and does not guarantee offers in selected areas.	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No
1st Choice:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
2nd Choice:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
3rd Choice:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
4th Choice:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
5th Choice:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No
Please select any additional areas you would accept an assignment match:	See Appendix p. 120	No	No	No	No	No	No	No	No	Yes	No

Table 6.8.1-b. Special Requirements Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Would you be willing to work in a rural setting?	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No
Would you be willing to work on an Indian reservation?	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No
Do you have a preference in the subject area you would like to work on? Please rank up to 5 subject area(s) that you would prefer to work in? (1-5 highest to lowest preference). Please note that your preference of subject area does not affect your rating or eligibility into the program. The information, when possible, is used for matching purposes only. Most importantly, while preferences may be taken into consideration, assignment offers are non-negotiable.	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No
1st Choice:	Subject Area Field Value Table	No	No	No	No	No	No	No	No	Yes	No
2nd Choice:	Subject Area Field Value Table	No	No	No	No	No	No	No	No	Yes	No
3rd Choice:	Subject Area Field Value Table	No	No	No	No	No	No	No	No	Yes	No
4th Choice:	Subject Area Field Value Table	No	No	No	No	No	No	No	No	Yes	No
5th Choice:	Subject Area Field Value Table	No	No	No	No	No	No	No	No	Yes	No
Please select any additional subject areas you would accept an assignment match:	Open text response	No	No	No	No	No	No	No	No	Yes	No
Do you have a valid Driver’s license from a state/territory in the USA?	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No
Do you own a car (privately owned vehicle: POV)?	1. Yes 2. No	No	No	No	No	No	No	No	No	Yes	No

FLIGHT
- Clinical Category & Training

Table 6.9.1-a. Clinical Category & Training Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Clinical Category:	1. Physician 2. Veterinarian	No	No	Yes	No	No	No	No	No	No	No
Please Upload CV:	File Upload Field			Yes							No
Have you taken FACT training?	1. Yes 2. No	No	No	Yes	No	No	No	No	No	No	No
Training Month:	Open text response	No	No	Yes	No	No	No	No	No	No	No
Training Year:	Open text response	No	No	Yes	No	No	No	No	No	No	No

Current EIS Position

Table 6.9.2-a. Current EIS Position.

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Team:	Open text response	No	No	Yes	No	No	No	No	No	No	No
Center/Division/Branch:	See Appendix p. 120	No	No	Yes	No	No	No	No	No	No	No
Specify:	Open text response	No	No	Yes	No	No	No	No	No	No	No

Current Primary Supervisor

Table 6.9.3-a. Current Primary Supervisor

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
First Name:	Open text response	No	No	Yes	No	No	No	No	No	No	No
Last Name:	Open text response	No	No	Yes	No	No	No	No	No	No	No
CDC Email:	Open text response	No	No	Yes	No	No	No	No	No	No	No
Work Phone:	Open text response	No	No	Yes	No	No	No	No	No	No	No

Scientific Experience

Table 6.9.4-a. Scientific Experience

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
First-authored manuscripts published in peer reviewed journals over the last ten years:	Open text response	No	No	Yes	No	No	No	No	No	No	No
First-authored manuscript submitted and currently being considered for publication in a peer reviewed journal:	Open text response	No	No	Yes	No	No	No	No	No	No	No
First-authored manuscripts currently undergoing CDC clearance:	Open text response	No	No	Yes	No	No	No	No	No	No	No
First-authored manuscripts currently in draft stage:	Open text response	No	No	Yes	No	No	No	No	No	No	No
First-authored abstracts presented at scientific conferences during EIS:	Open text response	No	No	Yes	No	No	No	No	No	No	No
Awards received during EIS:	Open text response	No	No	Yes	No	No	No	No	No	No	No

ELI
- Organization Details

INSTRUCTIONAL TEXT:

ELI Eligibility

Table 6.11.1-a. Organization Details Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Organization Name:	Open text response	No	No	No	No	No	No	No	Yes	No	No
Is this a public health organization?	1. Yes 2. No	No	No	No	No	No	No	No	Yes	No	No
Public Health Organization Type:	1. State 2. Local 3. Territorial 4. Tribal 5. International Health 6. University 7. Hospital 8. Other	No	No	No	No	No	No	No	Yes	No	No
Specify Public Health Organization Type:	Open text response	No	No	No	No	No	No	No	Yes	No	No
Position Title:	Open text response	No	No	No	No	No	No	No	Yes	No	No

Educational Experience

Table 6.11.2-a. Educational Experience Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Your Highest Degree Attained:	1. Bachelors 2. Masters or higher 3. Other related Certification 4. No Degree or Certification	No	No	No	No	No	No	No	Yes	No	No
Degree or Certification Type:	1. Education 2. Public Health / Sciences 3. Technology 4. Business 5. Other	No	No	No	No	No	No	No	Yes	No	No
Specify Degree or Certification Type:	Open text response	No	No	No	No	No	No	No	Yes	No	No
Degree or Certification Transcript:	Open text response	No	No	No	No	No	No	No	Yes	No	No

Work Experience

Table 6.11.3-a. Work Experience Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
What is your role in the development of training? (Select all that apply)	1. Instructional Designer or Trainer 2. Subject Matter Expert (SME) 3. Training Coordinator 4. Learning Management (LMS) Coordinator 5. Other	No	No	No	No	No	No	No	Yes	No	No
Specify Role:	Open text response	No	No	No	No	No	No	No	Yes	No	No
Do you have experience in developing training for public health audiences?	1. Yes 2. No	No	No	No	No	No	No	No	Yes	No	No
Please rate your experience:	1. Highly Experienced (Degree/certification or 5 - 10 years of experience) 2. Experienced (No degree but at least 5 years of experience) 3. Limited Experience (No degree and less than 5 years of experience)	No	No	No	No	No	No	No	Yes	No	No
How long have you been developing e-learning?	1. 0 years 2. Less than 1 year 3. 1 - 2 years 4. 3 years or more	No	No	No	No	No	No	No	Yes	No	No
Please describe your experience:	Open text response	No	No	No	No	No	No	No	Yes	No	No
Approximately how many training activities such as online courses or webinars does your organization create annually?	1. 1 - 10 2. 11 - 50 3. 51+	No	No	No	No	No	No	No	Yes	No	No
What percentage of your organization’s training activity is e-learning?	1. 0 - 25% 2. 26 - 50% 3. 51 - 75% 4. 76 - 100%	No	No	No	No	No	No	No	Yes	No	No

e-Learning Content Example

INSTRUCTIONAL TEXT:

We require that you submit an example of the content you would like to develop as e-learning.

Table 6.11.4-a. e-Learning Content Example Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Select the format of your e-learning content example submission:	-Document upload -Video File upload -Website link to content	No	No	No	No	No	No	No	Yes	No	No
Content Example Upload:	Select a file to upload	No	No	No	No	No	No	No	Yes	No	No
Website Link to Content Example:	Open text response	No	No	No	No	No	No	No	Yes	No	No

6.12 EIS, LLS, FLIGHT, PE, PHIFP

6.12.1 Federal Student Loan Repayment Interest

Table 12.1 Federal Student Loan Repayment Interest

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
INSTRUCTIONAL TEXT: The flowing information will not be used in the selection process. Do you have U.S. Federal Student loans? If response is No, STOP ELRPHP questions and go to next section	1.Yes 2.No	Yes	Yes	Yes	No	No	Yes	Yes	No	No	No
6.12.2 Before applying, were you aware of the Educational Loan Repayment Program for Health Professionals in which CDC/ATSDR recruits can receive up to $50,000 a year in loan repayment for a minimum 2-year service agreement? *Only ask if answered yes to question 6.12.1	1.Yes 2.No	Yes	Yes	Yes	No	No	Yes	Yes	No	No	No
Are you interested in Federal student loan repayment? (To learn more please visit the Educational Loan Repayment for Health Professionals information on the website). *Only if answered yes to question 6.12.1.	1.Yes 2.No	Yes	Yes	Yes	No	No	Yes	Yes	No	No	No
6.12.5 Did the availability of this loan repayment program influence your decision to apply for this fellowship? *Only if answered “yes” to interest in student loan repayment (6.12.4)	1.Yes 2.No										No

Table 6.13-a. Program Evaluation Skills and Experience

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
How would you assess your current level of knowledge/skill for program evaluation?	-Beginner -Advanced beginner -Intermediate -Advanced	No	No	No	No	No	No	No	No	No	Yes
How many years of experience do you have in program evaluation?	Open text response	No	No	No	No	No	No	No	No	No	Yes
List any special skills, research topics/experiences, or other areas of expertise that you have. (A list is acceptable)	Open Text Response	No	No	No	No	No	No	No	No	No	Yes

Confirming Accuracy & Minimum Eligibility

Table 6.14-a. Confirming Accuracy & Minimum Eligibility Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
By selecting the option below, you confirm that the information given in this form is true, complete, and accurate and that you meet the minimum eligibility requirements for this fellowship program?	1. I confirm that the information given in this form is true, complete, and accurate and that I meet the minimum eligibility.	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

INSTRUCTIONAL TEXT (depending on answer):

You are not eligible at this time to apply to this fellowship. Please review the eligibility requirements on the fellowship website. If you feel this is an error please contact the program.

7. Education & Licenses

Adding Education or Licenses

INSTRUCTIONAL TEXT:

Education & Licenses

Action required

Table 7.1-a. Adding Education or Licenses

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Please include educational background starting with your undergraduate experience. Medical and/or veterinary school information is required.	Open text response	No	No	No	Yes	No	No	No	No	No	No
Applicants who have received a foreign academic degree will be required to submit their transcripts for a foreign credential evaluation. This evaluation helps ensure that foreign degree requirements are equivalent to that in the United States.	New Instructional text						Yes

INSTRUCTIONAL TEXT:

You need to have a minimum of one item in this list to submit your entry. [Export .CSV] [Add New Item]

Choose Category

Table 7.2-a. Choose Category Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Do you want to proceed?	1. Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes
INSTRUCTIONAL TEXT (FOR EFP ONLY): Additional relevant Master’s or Doctoral degrees only
What do you want to add? (Active U.S. Clinical License for clinical applicants only)	1. Undergraduate Education 2. Graduate Education (includes degrees in progress) 3. Additional Coursework 4. Active U.S. Clinical License	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes

Coursework Type

Table 7.3-a. Coursework Type Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Which type of coursework do you need to add?	Open text response	No	No	No	No	No	Yes	No	No	No	No

Location

Table 7.4-a. Location Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Country:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes
State/Province:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes

College/University

Table 7.5-a. College/University Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
College/University:	See Appendix p. 120	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes
College/University:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes
If your college/university is not listed, please contact the System Help Desk Ticket	Open text response	Yes	Yes	No	Yes	Yes	No	No	No	No	No

Status

Table 7.6-a. Status Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Degree Status:	1. Current (Ongoing) 2. Graduated (Degree program) 3. Completed (Nondegree program) 4. Did not complete	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Has your degree been conferred?	1. Yes 2. No	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Course Status:	1. Current 2. Completed	No	No	No	No	No	Yes	No	No	Yes	No
License Status:	1. Expected 2. Received	Yes	Yes	Yes	No	No	No	No	No	Yes	No

7.7 Degree

Table 7.7-a. Degree Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Undergraduate Degree:	Undergraduate Degree List	Yes	Yes	Yes	Yes	Yes	No	No	Yes	Yes	No
Graduate Degree:	Graduate Degree List	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Other Degree:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Major 1:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Major 1 Classification:	Major Classification List	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Is this degree a double major?	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	No
Major 2:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	No
Major 2 Classification:	Major Classification List	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	No
Minor/Certificate/Specialty:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	No
Grade Point Average (GPA):	Open text response	Yes	Yes	No	Yes	No	No	No	Yes	Yes	No
Did you complete a thesis or dissertation?	Yes No	Yes	Yes	No	Yes	No	Yes	Yes	No	Yes	No
Title And Abstract	Multi-line response	No	No	No	No	No	Yes	Yes			No
Is this a master’s thesis or dissertation?	Yes No	No	No	No	No	No		Yes			No
Description of Dissertation	Open text response	Yes	Yes	No	No	No	No	No	No	No	No
Did you receive academic honors?	1. Yes 2. No	Yes	Yes	No	Yes	No	Yes	No	No	Yes	No
Honor Types:	Honor List	Yes	Yes	No	Yes	No	Yes	No	No	Yes	No
Instructional text for EFP Only: Transcripts should be for your qualifying/highest degree at the doctoral or master’s level. The qualifying degree is the one most related to the CDC’s work in public health and evaluation. If selected as a Fellow, your qualifying degree is one of the factors that determines your salary. If you have multiple graduate degrees (master’s or doctorate) and you are unsure of which degree qualifies, then submit official transcripts for all doctoral and master’s degrees that you have. Transcripts issued to student are acceptable but if selected, must submit official transcripts directly issued to CDC no later than early June. You’ll need to prepare for this is you’re selected given the quick turnaround. Official transcripts will need to be issued to “CDC Evaluation Fellowship and CDC Human Resource”. If your academic institution does not have electronic official transcripts available, then please discuss with the Fellowship as soon as selected. The transcript must state degree of study, courses taken, earned grades, and graduation/confer date. If from non-U.S. academic institution, you must provide a letter from a credentialing company that evaluated and certified your degree is equivalent to US-accredited academic institution. All transcripts must be translated into English.
Transcript Upload:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes
MPH Certificate Upload:	Open text response	No	No	No	No	No	No	No	No	No	No
Please acknowledge that you have uploaded a foreign credential evaluation for transcript issued by a non-U.S. institution.	1. Yes 2. No	No	Yes	No	No	No	No	No	No	No	No

Additional Coursework

Table 7.8-a. Additional Coursework Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Number of Credits:	Open text response	No	No	No	No	No	Yes	No	No	Yes	No
Course Name:	Open text response	No	No	No	No	No	Yes	No	No	Yes	No

License

Table 7.9-a. License Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Issuing State:	See Appendix p. 120	Yes	Yes	Yes	No	No	No	No	No	No	No
License Number:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No
License Upload:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No

7.10 Dates

Table 7.10-a. Date Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP
Attended From:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No
Attended To:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No
Expected Completion Date:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	No
Degree Conferral Date:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	Yes	Yes
PhD Defense Date:	Open text response	Yes	Yes	No	No	No	Yes	Yes	No	Yes	No
License Expected Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No
License Received Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No
License Expiration Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No

Incomplete Reason

Table 7.11-a. Incomplete Reason Field

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Incomplete Reason (Note: List expected graduation date if degree is still in progress):	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No

Work & Volunteer Experience

8.1 Adding Work or Volunteer Experience

INSTRUCTIONAL TEXT:

Work & Volunteer experience

Action required

Please list work and volunteer experience in chronological order

You need to have a minimum of 1 item in this list in order to submit your entry. [Export .CSV] [Add New Item]

8.2 Choose Category

Table 8.2-a. Choose Category Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Do you want to proceed?

1. Yes

Yes

What do you want to add?

For Volunteer Experience, please list activities outside your normal working hours/responsibilities.

1. Work Experience
2. Volunteer Experience

Yes

Organization Details

Table 8.3-a. Organization Details Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Organization Name	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Organization Type	1. Additional education or training (including degree or residency programs, fellowships and post-doctoral research positions) 2. Government – CDC (including contractor work) 3. Government – non-CDC federal government (including contractor work) 4. Government – state, tribal, local, or territorial health agency (including contractor work) 5. Non-governmental, community, or other organization (NGO) 6. Academia (as faculty or staff) 7. Industry (private, non-clinical business) 8. Clinical work	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Does your organization, school or school district receive Title 1 financial assistance?	1. Yes 2. No 3. N/A 4. Prefer not to respond	No	No	No	No	Yes	No	No	No	No	No
May we contact your supervisor?	1. Yes 2. No	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Supervisor Name	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Supervisor Phone Number	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Supervisor Email	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Reason	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No

Position Details

Table 8.4-a. Position Details Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Title	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Hours Per Week	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Is this position related to public health?	1. Yes 2. No	Yes	Yes	No	Yes	No	Yes	Yes	No	No	No
Duties and Responsibilities	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Accomplishments	Open text response	Yes	No	No	No	No	Yes	No	No	No	No
Extracurricular Duties/Responsibilities (e.g., advisor, board member, committee chair, coach, teacher association president)	Open text response	No	No	No	No	Yes	No	No	No	No	No
Full-time or part-time?	1. Part Time (<30 hours per week) 2. Full Time (>30 hours per week)	No	No	No	Yes	No	No	No	No	No	No

Dates

Table 8.5-a. Date Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Dates From	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Is this a current position?	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Dates To	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Reason for Leaving	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No

Position Location

Table 8.6-a. Position Location Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Address	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Address Line 2	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Address Line 3	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Country	See Appendix p. 120	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
State/Territory:	See Appendix p. 120	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
State/Province	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
City	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Zip/Postal Code	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No

Additional Training & Skills

Adding Additional Training & Skills

INSTRUCTIONAL TEXT:

Please list only the most relevant training and skills pertinent to your EIS application. List experiences in chronological order.

Additional Training & Skills

Action Required

You need to have a minimum of 1 item in this list in order to submit your entry [Export .CSV] [Add New Item]

Choose Category

Table 9.2-a. Choose Category Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP
Do you want to proceed?	1. Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
What do you need to add?	1. Clinical Training 2. U.S. Clinical Board Certification 3. Additional Training, Certification or Professional Development 4. Language Skill 5. None of the Above	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No

9.3 Clinical Training

Table 9.3-a. Clinical Training Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Title:	Open text response	Yes	Yes	No	No	No	Yes	No	No	No	No
Certification of completion of clinical training upload:	Upload Field										No
May we contact your supervisor?	1. Yes 2. No	Yes	Yes	No	No	No	Yes	No	No	No	No
Supervisor Name:	Open text response	Yes	Yes	No	No	No	Yes	No	No	No	No
Supervisor Email:	Open text response	Yes	Yes	No	No	No	Yes	No	No	No	No
Supervisor Phone Number:	Open text response	Yes	Yes	No	No	No	Yes	No	No	No	No
Reason:	Open text response	Yes	Yes	No	No	No	Yes	No	No	No	No

9.4 U.S. Board Certifications and Specialty

Table 9.4-a. Clinical Training Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Status:	1. Certified 2. Eligible	Yes	Yes	Yes	No	No	No	No	No	No	No
Certificate of Completion Upload:	Upload Field										No
Specialty:	See Appendix p. 120	Yes	Yes	Yes	No	No	Yes	No	No	No	No
Specify Specialty:	Open text response	Yes	Yes	Yes	No	No	Yes	No	No	No	No

9.5 Additional Training, Certifications, or Professional Development

Table 9.5-a. Additional Training, Certifications, or Professional Development Fields

INSTRUCTIONAL TEXT:

Include significant trainings or other experiences providing at least 8 hours of training or resulting in a certification.

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Training Name:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Description:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Certification Upload:	Open text response	Yes	Yes	No	No	No	Yes	Yes	No	No	No

Institution Details and Location

Table 9.6-a. Institution Details and Location Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Institution Name:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Country:	See Appendix p. 120	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
State/Territory:	See Appendix p. 120	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
State/Province:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
City:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No

Dates

Table 9.7-a. Date Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Dates From:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Are you currently pursuing?	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Dates To:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No
Expected Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No
Most Recent Issuance Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No
Most Recent Expiration Date:	Open text response	Yes	Yes	Yes	No	No	No	No	No	No	No

Language Skills

Table 9.8-a. Language Skill Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Language:	See Appendix p. 120	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Other Language:	Open text response	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Read:	1. Poor 2. Fair 3. Good 4. Excellent	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Write:	1. Poor 2. Fair 3. Good 4. Excellent	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Speak:	1. Poor 2. Fair 3. Good 4. Excellent	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No

Table 9.9-a. Additional Skills: Computer and Statistical Software Skills

Please select the statistical software package(s) for which you have Proficient/Skilled or Mastery/Expert competency [SELECT ALL THAT APPLY]:

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
SAS	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No
STATA	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No
Epi-Info	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No
R	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No
Excel	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No
Other (Specify and Provide Rating)	Proficient/Skilled Master/Expert	No	No	No	Yes	No	No	No	No	No	No

10. Publications, Presentations, Working Papers, Monographs or Reports, Grants, Honors and Awards

10.1 Adding Publications, Presentations, Working Papers, Monographs or Reports, Grants, Honors and Awards

INSTRUCTIONAL TEXT

Please enter your publications listed in chronological order following Pubmed/Medline format https://www.nlm.nih.gov/bsd/policy/cit_format.html

Publications, Presentations, Grants, Working Papers, Honors and Awards

Action required

You need to have a minimum of 1 item in this list in order to submit your entry.

10.2 Choose Category

Table 10.2-a. Choose Category Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Do you want to proceed?

1. Yes

Yes

What do you want to add?

FOR LLS: For Honors and Awards, please do not list academic scholarships.

INSTRUCTIONAL TEXT:

Separate oral presentations and poster presentations

1. Publications
2. Presentations
3. Grants
4. Honors or Awards
5. Monographs or Reports
6. Research Grants
7. Working Papers (Job Market Papers)

Yes

10.3 Details

INSTRUCTIONAL TEXT

Publications

Please enter all publications in the same entry; do not create a separate entry for each publication.

In the Details box below, please list all publications and include the following information for each:

Citation

Presentations

Please enter all presentations in the same entry; do not create a separate entry for each presentation.

In the Details box below, please list all presentations and include the following information for each:

Citations
Types of presentations
Titles
Conferences
Dates of Conferences

Monographs or Reports

Please enter all monographs or reports in the same entry; do not create a separate entry for each monograph or report.

In the Details box below, please list all monographs or reports and include the following information for each:

Citations (or descriptions if no formal citations)

Working Papers (Job Market Papers)

Please enter all working papers (job market papers) in the same entry; do not create a separate entry for each working paper.

In the Details box below, please list all working papers (job market papers) and include the following information for each:

Titles
Abstracts

Grants

Please enter all grants in the same entry; do not create a separate entry for each grant.

In the Details box below, please list all grants and include the following information for each:

Titles
Your roles
Dates awarded
Funding agencies
Amounts awarded

Research Grants

Please enter all research grants in the same entry; do not create a separate entry for each research grant.

In the Details text box below, please list all competitive research grants and include the following for each:
Titles
Your roles
Dates awarded
Funding agencies
Amounts awarded
Abstracts

Honors or Awards

Please enter all honors and awards in the same entry; do not create a separate entry for each honor/award.

In the Details box below, please list all honors or awards and include the following information for each:

Names of Organizations Bestowing
Names of honors or awards
Types
Dates awarded

INSTRUCTIONAL TEXT: Refer to the National Library of Medicine sample references for preferred citation format

Table 10.3-a. Detail Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Details:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	No	No	No

11 Personal Statement

11.1 All Fellowships except FLIGHT

INSTRUCTIONAL TEXT

Write your personal statement by considering these questions (in 300 words for each):

What influenced you to consider a career in public health service?
Describe how this fellowship/program will help you achieve your goals.
Understanding that there are different topical and geographical assignments, in which do you prefer to work and why?
For re-applicants: When did you apply and what has changed since your last application?

Figure 11.1-a. Personal Statement Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
What influenced you to consider a career in public health service?	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	Yes	No
Describe how this fellowship/program will help you achieve your goals.	Open text response	Yes	Yes	No	Yes	Yes	No	Yes	No	Yes	Yes
What are your goals and how will this program help you achieve your goals?	Open text response	No	No	No	Yes	Yes	Yes	Yes	No	Yes	No
Describe your greatest professional challenge so far and how you overcame it.	Multi-line text	No	No	No	No	No	No	Yes	No	No	No
Describe your use of economic or decision-analytic methods. What methods would you like to learn more about?	Multi-line text	No	No	No	No	No	No	Yes	No	No	No
Why are you interested in this fellowship/program?	Open text response	No	No	No	No	No	No	Yes	Yes	Yes	No
What makes you a good candidate for this fellowship/program?	Open text response	No	No	No	No	No	No	Yes	Yes	Yes	No
Why do you want to join the CDC?	Open text response	No	No	No	No	No	No	Yes	No	No	No
How do your values align with the core CDC values?	Open text response	No	No	No	No	No	No	No	No	Yes	No
Understanding that there are different topical and geographical assignments, in which do you prefer to work and why?	Open text response	Yes	No	No	Yes	No	No	No	No	No	No
How do you anticipate using the concepts and skills learned in this fellowship/program? Be as specific as possible.	Open text response	No	No	No	No	Yes	No	Yes	Yes	No	No
Describe the two most important skills you want to develop or improve during this fellowship/program.	Open text response	No	Yes	No	No	No	No	No	Yes	No	Yes
What do you believe are facilitators at your organization for developing e-learning?	Open text response	No	No	No	No	No	No	No	Yes	No	No
What do you believe are barriers at your organization for developing e-learning?	Open text response	No	No	No	No	No	No	No	Yes	No	No
Describe your proficiency using e-learning software. Include the authoring tool/s used at your current organization.	Open text response	No	No	No	No	No	No	No	Yes	No	No
What is your experience incorporating new content into your curricula? Please provide at least one example.	Open text response	No	No	No	No	Yes	No	No	No	No	No
Describe your experience related to data management and analysis, including the use of statistical software packages such as Excel, SAS, STATA, R, or Epi Info. Please provide specific examples. Note that this question will be used to assist the program with matching applicants to appropriate host sites.	Open text response	No	No	No	No	No	No	Yes	No	No	No
For re-applicants: When did you apply and what has changed since your last application?	Open text response	Yes	Yes	No	Yes	Yes	No	No	No	No	No
Please describe what qualifies you for the CDC Evaluation Fellowship Program	Open Text Response	No	No	No	No	No	No	No	No	No	Yes
Instructional text: Be specific, although titles for all courses are not necessary. A list is acceptable.
Briefly provide some information on your formal training (classroom or otherwise) where all or part of the focus was on program evaluation approaches, methods, techniques, etc.	Open Text Response	No	No	No	No	No	No	No	No	No	Yes
Instructional text: The diverse representation is more than demographics (e.g., age, sex, gender, race, culture) as it can include different disciplines, personalities, types of organizations, etc. This experience does not have to be specific to a project or to evaluation.
Briefly describe up to three program evaluation projects you worked on. Please include your role in the project, evaluation approach and methods used, and outcomes or impact of the project.	Open Text Response	No	No	No	No	No	No	No	No	No	Yes
Please describe your lived experience and/or experience working in a setting (e.g., work environment or situation), collaboration, or context where there is diverse representation in perspectives, background, and/or culture. Please describe how the environment, situation, or context is diverse and your approach to bringing different people, perspectives, and background together. Please describe how you may have considered for diversity, equity, belonging, inclusion, and accessibility (DEBIA).	Open Text Response	No	No	No	No	No	No	No	No	No	Yes

11.2 FLIGHT

Table 11.2-a. FLIGHT Personal Statement Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
1. Tell us the characteristics, skills, and abilities that make you the best candidate for this scientific leadership program.	Open text response	No	No	Yes	No	No	No	No	No	No	No
2. Tell us what the two most important skills you want to develop or improve after finishing EIS.	Open text response	No	No	Yes	No	No	No	No	No	No	No
3. Elaborate on your most significant accomplishment during your EIS fellowship.	Open text response	No	No	Yes	No	No	No	No	No	No	No
4. Describe the biggest challenge you faced during EIS, and how you overcame that challenge.	Open text response	No	No	Yes	No	No	No	No	No	No	No
5. Tell us your career goals after graduating from this leadership program, and how this leadership program will help you achieve them.	Open text response	No	No	Yes	No	No	No	No	No	No	No

11.3 Location Preferences

Table 11.3-a. Location Preference Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
What is your preference for location of assignment?	1. I am only interested in CDC Headquarters assignments. 2. I am only interested in state assignments 3. I am interested in CDC Headquarters assignments and state assignments.	Yes	Yes	No	No	No	Yes	Yes	No	No	No
To which states or territories would you be willing to relocate for the duration of the 2-year EIS fellowship?”	State/Territory List	Yes	No	No	No	No	Yes	Yes	No	No	No
Do you have geographic constraints on where you can relocate for your fellowship/program?	1. Yes 2. No	Yes	Yes	No	Yes	No	Yes	Yes	No	Yes	No
Please explain:	Open text response	Yes	Yes	No	Yes	No	Yes	Yes	No	Yes	No

11.4 CDC Fellowship Participation

Table 11.4-a. CDC Fellowship Participation Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Have you participated in any CDC fellowship programs?	1. Yes 2. No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Please select all CDC fellowships that you have participated in:	CDC Fellowship List	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

12Standardized Letters of Recommendation (SLOR)

12.1 SLOR Requests

12.1.1 Starting a SLOR Request

INSTRUCTIONAL TEXT:

Letters of Recommendation

Action Required

You need to have a minimum of 1 item in this list in order to submit your entry [Export .CSV] [Add New Item]

INSTRUCTIONAL TEXT FOR LLS:

Identify two people who can provide recommendations on your behalf using our standardized online form.

Select 2 individuals who have served in a supervisory or mentoring role and are familiar with your academic achievements, aspirations, personal qualities, and professional attributes. These individuals should provide recommendations specific to your LLS fellowship application.

Avoid requesting letters from colleagues or friends. Recommendations must be written in English.

Request/confirm their email address.

Tell recommendation writers to expect a system-generated email from [email protected] with instructions for electronically submitting their responses to questions in a standardized recommendation form.

One of the two standardized letters of recommendation must be from persons who are not currently employed at the CDC.

Table 12.1.2-a. LOR Request Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Recommender's Name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Organization:	Open text response	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Job Title:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Dean of Medical School?	1. Yes	Yes	No	No	Yes	No	Yes	Yes	No	Yes	Yes
Phone:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Email:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Relationship to you:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Note to the recommender:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
You confirm that your supervisor is aware and in support of your application to this fellowship?	1. Yes, I confirm	No	No	No	No	No	No	No	Yes	No	Yes
You confirm that your supervisor is aware that the deliverable of this fellowship is an e-learning product that takes less than 20 minutes to complete and that your product must be submitted at the end of the fellowship and listed on the TRAIN network?	1. Yes, I confirm	No	No	No	No	No	No	No	Yes	No	Yes
Letter of Recommendation Waiver Agreement:	1. "In order to be considered for the fellowship program, I agree to waive my right to view any recommendations submitted for me."	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
By selecting the option below, you confirm that the application information given in this form is true, complete, and accurate. Three standardized letters of recommendation are required from persons familiar with your academic achievements, aspirations, personal qualities, and professional attributes. Two of the standardized letters of recommendation must be from persons who are not currently employed at the CDC. If you are currently employed at CDC, you may request a fourth letter if, in addition to 2 letters from non-CDC employees, you would like to submit 2 letters from current CDC employees. -Recommenders should typically be current or former supervisors or professors. Avoid requesting letters from colleagues or friends. -Recommendations must be written in English. -Let recommenders know you are requesting a recommendation and tell them to expect an email with a link to the online form that they should use to complete the standardized letter of recommendation. Traditional narrative letters of recommendation and MSPE (Dean’s letter format) are not accepted.	Open text response	Yes	No	No	No	No	No	No	No	No	Yes

12.2 System Emails to Letter Writers

12.3 Letters of Recommendation

12.3.1 Section A

INSTRUCTIONAL TEXT:

Provide as much relevant detail as you can for each response

Figure 12.3.1-a. Section A Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Name of person submitting the recommendation form:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Title of person submitting the recommendation form:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Organization name:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Phone number:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Number of persons with similar background to the candidate that you supervised over last 5 years:	1. <= 1 2. 2 - 5 3. 6 - 10 4. > 10	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Name of person for whom this recommendation is being submitted:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
In what role are you providing this reference?	1. Supervisor 2. Advisor 3. Program director 4. Dean 5. Professor 6. Faculty member 7. Thesis committee member 8. Other (Explain)	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Explain:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
How long have you known the candidate?	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Describe your role working or collaborating with this person:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
On average, how often have you worked with, or do you work with, the candidate (For example: average of 5 days per week over the past 6 months, or occasional interaction over the past 10 years).	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

12.3.2 Section B

Table 12.3.2-a. Section B Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Compared with other similar individuals at similar points in their careers, how do you rank this candidate at developing effective working relationships with a variety of different people?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	Yes	Yes	No	Yes	Yes	No	No	Yes	Yes	Yes
Please provide an example(s) about this candidate’s experience developing effective working relationships, e.g., with internal or external partners, team members, or state/local health professionals.	Open text response	Yes	Yes	No	No	No	Yes	Yes	Yes	Yes	Yes
Compared with other similar individuals at similar points in their careers, how do you rank this candidate at managing tasks or projects?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	No	Yes	No	Yes	No	No	No	Yes	Yes	Yes
Please provide an example that describes the effectiveness of task or project management, e.g., was management of tasks and projects timely, complete, and responsive.	Open text response	No	No	No	No	No	Yes	Yes	Yes	Yes	Yes

Table 12.3.2-b. Section B Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Compared with other similar individuals at similar points in their careers, how do you rank this candidate at effectively prioritizing efforts?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	Yes	No	No	No	No	No	No	Yes	No	No
Please provide an example that describes the effective prioritization of efforts, e.g., could this candidate identify and act on the most important tasks first?	Open text response	Yes	No	No	No	No	No	Yes	Yes	No	No
Compared with other similar individuals at similar points in their careers, how do you rank this candidate’s ability to take initiative?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	Yes	Yes	No	Yes	Yes	No	No	No	Yes	Yes
Please provide an example that describes the candidate’s ability to take initiative, e.g., did this person actively seek to identify issues and address them without being told?	Open text response	Yes	Yes	No	No	No	No	Yes	No	Yes	Yes
Compared with other similar individuals at similar points in their careers, how well did this candidate respond to constructive feedback?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	Yes	Yes	No	Yes	Yes	No	Yes	Yes	Yes	Yes
Please provide an example(s) of how the candidate responded to constructive feedback. This could include feedback on e.g., their performance, behavior, or scientific work.	Open text response	Yes	Yes	No	No	No	No	Yes	Yes	Yes	Yes

Table 12.3.2-c. Section B Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Compared with other similar individuals you have supervised or advised, how do you rank the candidate’s knowledge of health data, methods, and analytics?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	No	No	No	Yes	No	No	Yes	No	No	No
Please provide an example(s) of the candidate’s knowledge of health data, methods, and analytics.	Open text response	No	No	No	No	No	No	Yes	No	No	No
Compared with other similar individuals you have supervised or advised, how do you rank the candidate’s flexibility and resilience?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	No	No	No	Yes	No	No	Yes	No	Yes	No
Please provide an example(s) of the candidate’s flexibility and resilience.	Open text response	No	No	No	No	No	No	Yes	No	Yes	No
Compared with other similar individuals you have supervised or advised, how do you rank the candidate’s self-advocacy?	1. Below average (Bottom 50%) 2. Average (50% to 75%) 3. Above Average (Top 25%) 4. Excellent (Top 10%) 5. Superior (Top 2%) 6. Not able to judge	No	No	No	Yes	No	No	Yes	No	No	No
Please provide an example(s) when the candidate advocated successfully on behalf of themselves and their work.	Open text response	No	No	No	No	No	No	Yes	No	No	No
Do you have any concerns about this applicant and their potential performance in this fellowship/program?	Open text response	Yes	Yes	No	No	No	No	Yes	No	Yes	Yes
Explain the strongest reason/s that we should consider for selecting this candidate.	Open text response	No	No	No	No	No	No	Yes	No	Yes	No

Table 12.3.2-b. PHAP Section B Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Compared with other similar individuals you have supervised or advised, how do you rank the candidate’s integrity?

1. Below average (Bottom 50%)

2. Average (50% to 75%)

3. Above Average (Top 25%)

4. Excellent (Top 10%)

5. Superior (Top 2%)

6. Not able to judge

Yes

Please provide an example(s) that describes his/her integrity, e.g., demonstration of honesty and candor, or witnessed an instance where the candidate lied to avoid or delay consequences.

Yes

Section C

Table 12.3.3-a. Section C Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
As a candidate for this fellowship/program, I consider the applicant:	1. Not suitable 2. Minimally suitable 3. Suitable 4. Very suitable	No	Yes	No	No	No	No	No	No	No	No
As a candidate for this fellowship/program, I consider the applicant:	1. Not suitable 2. Minimally suitable 3. Suitable 4. Very suitable 5. Most suitable ever	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Please describe the specific skills and attributes of the candidate that make them suitable for this fellowship/program:	Open text response	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Any other comments:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Enter your initials:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Enter today's date:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

13. Final Application Sections

13.1 Self-Assessment of Skills

13.1.1 PHIFP

Table 13.1.1-a. PHIFP Self-Assessment of Skills Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
1. Data Sciences (Wrangling, Cleansing, Modeling, Analytics):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Data Sciences Experience:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
2. Data Science Methods (e.g. machine learning, NLP, deep learning):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Data Science Methods Experience:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
3. DataViz (Storytelling using Data, DataViz methods and tools, Dashboard design):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
DataViz Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
4. Database Design and Development (Big Data, data modeling, information retrieval):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Database Design and Development Experience:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
5. Programming Languages and Scripting (Python, R, C, C++, Java, Scala, C#, JavaScript, PHP):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Programming Languages and Scripting Experience:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
6. Distributed Computing (Cloud Computing, Grid computing):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Distributed Computing Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No

Table 13.1.1-d. PHIFP Self-Assessment of Skills Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
7. Design Thinking (UI design, Prototyping, Human Computer Interaction):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Design Thinking Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
8. Systems Engineering (Concept Development, Requirements Engineering, System Architecture, System Design and Development, Systems Integration, Testing, Implementation, Compliance tracking and Certification):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Systems Engineering Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
9. Project Management (Project Scoping, Risk Management, Project Management tools):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Project Management Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
10. Data Exchange and Interoperability (Data and Systems standards, HL7, LOINC, SNOMED, Vocabulary Standards, Concept Dictionaries, Ontologies):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Data Exchange and Interoperability Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
11. Public Health Information Systems (Clinical/PH decision support systems, Electronic Health Records, outbreak management systems, surveillance systems; ODK, DHIS2, REDCap, GIS, EpiInfo):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Public Health Information Systems Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No
12. Emerging Technologies (Blockchain and Distributed Ledger Technologies, Artificial Intelligence, Sensor Technologies):	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	No	No	No	No
Emerging Technologies Experience:	Open text response	No	No	No	No	No	Yes	No	No	No	No

13.1.2 PE

INSTRUCTIONAL TEXT:
This section is to determine your skills level and experience with various software applications and data sets that are routinely used in health research.

Table 13.1.2-a. PE Self-Assessment of Skills Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
STATA:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
SAS:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
R:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
MATLAB:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Excel:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No

Table 13.1.2-b. PE Self-Assessment of Skills Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Instructions: If desired, list up to three additional software applications (i.e., DataViz, GIS, etc.) that you routinely use in health research and indicate your level of experience with each software.							Yes				No
Other Software #1:							Yes	Yes			No
Other Software #1 Skill Level:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Other Software #2:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
Other Software #2 Skill Level:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No
Other Software #3:	Open text response	No	No	No	No	No	Yes	Yes	No	No	No
Other Software #3 Skill Level:	1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert	No	No	No	No	No	Yes	Yes	No	No	No

Figure 13.1.2-c. PE Self-Assessment of Skills Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
List the data sets where you have Competent, Proficient, or Expert experience and indicate your level experience for each. (Competent, Proficient, or Expert):	Open text response	No	No	No	No	No	No	Yes	No	No	No

13.2 Applicant Survey

Table 13.2-a. Applicant Survey Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Do you want to proceed?	1. Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Which of the following most influenced you to apply to this fellowship? (select up to 3)	Change type: Question revision Which of the following most influenced you to apply to this fellowship? (select up to 3) Handshake (e.g., job posting, fellow/alumni ambassador) Other job search platform (e.g., Indeed, ZipRecruiter, Job Openings for Economists) In-person event (e.g., conference booth) News advertising (e.g., online ad, news media) Newsletter or email listserv (e.g., from CDC, your university, professional organization) Social Media (e.g., Facebook, LinkedIn, Instagram, Twitter, YouTube) Webinar or other virtual event (e.g., information session, alumni panel) Word of mouth (e.g., from current or former fellow, professor, supervisor) Other (please specify)	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Specify:	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
How did you connect with the person who told you about the fellowship by word of mouth? (Select all that apply) Include an open-ended box that asks to please specify If they selected word of mouth from 13.2.a question above.	1.Handshake (e.g., webinar, email, fellowship ambassador) 2.University event, webinar, presentation 3.CDC event, webinar, presentation, booth 4.Other event, webinar, presentation (specify) 5.Professional or academic setting (e.g., professor, mentor/supervisor, colleague) 6.Other (specify)	No	No	Yes	No	No	Yes	Yes	Yes	Yes	No
Specify: Note to admin: Only to be used if 4 or 6 are chosen in previous question	Open text response	No	No	Yes	No	No	Yes	Yes	Yes	Yes	No
*On what job search platform did you find out about the fellowships? Only if job search platform is selected from question 13.2.a.**	1.Handshake 2.Indeed 3.JOE (Job Openings for Economists 4.USAJobs 5.INFORMS 6.Other (specify)	No	No	Yes	No	No	Yes	Yes	Yes	Yes	No
Specify: Note to admin: If previous response was 6	Open text response	No	No	Yes	No	No	Yes	Yes	Yes	Yes	No
What other opportunities (e.g. jobs, fellowships, etc.) are you considering?	Open text response	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Are you applying to the EIS-IDSA Fellowship [name subject to change]	Yes No	Yes	No	No	No	No	No	No	No	No	No
If yes, which infections disease fellowships are you applying to?	Open Text Response	Yes	No	No	No	No	No	No	No	No	No
Q. Will the US Military or other federal agency provide complete financial support for your 2-year fellowship period? If YES, Please provide the name of the service and the contact information of the person who can confirm you have received approval to participate in EIS.	Yes No	Yes	No	No	No	No	No	No	No	No	No

Table 13.2-b. LLS Applicant Survey Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

What would make the LLS program more attractive to you? (select all that apply)

1. A longer fellowship term (e.g., 3 years)

2. A fellowship term that includes time spent at both a field (state or local lab) and CDC headquarters host site laboratory

3. Field experiences that require extended (e.g., 3 to 6 months) stays away from the host site laboratory (e.g., outside Atlanta if hosted at CDC headquarters)

4. Nothing

5. Other, please explain ___________.

Yes

Figure 13.2-b. Applicant Survey Fields – My Demographics

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
New Instructional Text: Your response is voluntary, confidential and will be used to enhance the federal government’s understanding of its fellowship programs. This information will not influence selection for the fellowship.		Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
What is your Ethnicity?	-- Hispanic or Latino -- Not Hispanic or Latino	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
What is your Race? (select all that apply):	-- American Indian or Alaska Native -- Asian -- Black or African American -- Native Hawaiian or Other Pacific Islander -- White	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

EEP Rotation Preferences & Topic/Subject Areas

Rotation Preferences

INSTRUCTIONAL TEXT:

Please complete this section as honestly as possible. Finalists are matched to a rotation and project assignment based on these preferences and selected to participate in the program upon acceptance of this match. If the finalist does not accept the match, there is no guarantee of a second match or selection to the program.

Rotation Preference:

Rotation A: January 13- February 21

Rotation B: January 13- March 6

Rotation C: March 23- May 1

Rotation D: March 23- May 15

Dates change each year

Table 13.3.1-a. Rotation Preference Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Rotation A:	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No
Rotation B:	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No
Rotation C:	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No
Rotation D:	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No

13.3.2 Topic & Subject Areas

Table 13.3.2-a. Topic & Subject Area Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Topic Area(s) Preference:

1. Obesity, nutrition, and physical activity

2. Cancer prevention and control

3. Diabetes

4. Heart disease and stroke prevention

5. Tobacco prevention and cessation

6. Other chronic disease

7. Emergency preparedness and response

8. Asthma and air pollution

9. Environmental health

10. Immunizations/vaccine preventable disease

11. Influenza

12. HIV/AIDS, or Tuberculosis

13. STD prevention

14. Viral hepatitis

15. Foodborne diseases

16. Waterborne diseases

17. Vectorborne diseases

18. Fungal Diseases

19. One Health and zoonotic disease

20. Arctic Investigations (Alaska)

21. Healthcare-associated infections

22. Quarantine and border health services

23. Unintentional injury

24. Opioid/prescription drug overdose prevention

25. Occupational health and safety

26. Violence Prevention

27. Reproductive Health

28. Maternal and infant health

29. Blood Disorders

30. Health statistics

31. State, local, and territorial health

32. Global health

33. COVID-19

34. Other (specify)

Yes

Specify:

Open text response

Yes

Table 13.3.2-b. Topic & Subject Area Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Project Type Preference:	1. Data collection 2. Data entry 3. Data analysis 4. Intervention/program planning 5. Intervention/program implementation 6. Intervention/program evaluation 7. Literature review 8. Scientific writing (e.g., drafting a section of a report) 9. Communications/design (e.g., developing flyers, website content) 10. Field investigation 11. Other:	No	No	No	Yes	No	No	No	No	No	No
Specify:	Open text response	No	No	No	Yes	No	No	No	No	No	No

13.3.3 Location Preferences

Table 13.3.3-a. Location Preference Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
What is your preference for the location of your project assignment? (Select all that apply)	1. CDC headquarters or Atlanta regional campuses (Atlanta, Georgia) 2. Other CDC Regional Campuses 3. Other Federal Agencies 4. State, local, or territorial health departments CDC Country Office (Remote)	No	No	No	Yes	No	No	No	No	No	No
Other CDC Regional Campuses (Select all that apply):	1. Anchorage, Alaska 2. Ft. Collins, Colorado 3. San Juan, Puerto Rico 4. Hyattsville, Maryland 5. Morgantown, West Virginia 6. Cincinnati, Ohio 7. Pittsburgh, Pennsylvania 8. Spokane, Washington 9. Denver, Colorado 10. Durham, North Carolina 11. Washington, DC 12. I am open to locations not listed above	No	No	No	Yes	No	No	No	No	No	No
Other Federal Agencies (Select all that apply):	National Park Service (Fort Collins, Colorado) National Park Service (Albuquerque, New Mexico) National Park Service (Washington, DC) Indian Health Service (varies) I am open to additional federal agencies not already listed above	No	No	No	Yes	No	No	No	No	No	No
State, local, or territorial health departments (Select all that apply):	State/Territory List	No	No	No	Yes	No	No	No	No	No	No
What type of work settings are you open to? (select all that apply, please note that the EEP program cannot guarantee a specific work setting):	In person (100%) Telework/remote (100%) Hybrid, mostly in person (>50%) Hybrid, mostly telework/remote (<50%)										No

13.4 SAF Public Health Interests

INSTRUCTIONAL TEXT:

From the list below rank the public health areas of most interest to you, with one being your top choice. The information will be used to group you into lesson plan development teams during the workshop.

Table 13.5-a. SAF Public Health Interests Fields

Field

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

First [Second | Third] Choice Area

1. Obesity, nutrition, and physical activity

2. Cancer prevention and control

3. Diabetes

4. Heart disease and stroke prevention

5. Tobacco prevention and cessation

6. Other chronic disease

7. Emergency preparedness and response

8. Asthma and air pollution

9. Environmental health

10. Immunizations/vaccine preventable disease

11. Influenza

12. HIV/AIDS, or Tuberculosis

13. STD prevention

14. Viral hepatitis

15. Foodborne diseases

16. Waterborne diseases

17. Vectorborne diseases

18. Fungal Diseases

19. One Health and zoonotic disease

20. Arctic Investigations (Alaska)

21. Healthcare-associated infections

22. Quarantine and border health services

23. Unintentional injury

24. Opioid/prescription drug overdose prevention

25. Occupational health and safety

26. Violence Prevention

27. Reproductive Health

28. Maternal and infant health

29. Blood Disorders

30. Health statistics

31. State, local, and territorial health

32. Global health

33. COVID-19

34. Other (specify)

Yes

Other First [Second | Third] Choice Area

Yes

13.5 EIS CIO Assignment Interests

INSTRUCTIONAL TEXT:

From the list below, indicate the CDC Centers, Institute, or Offices (CIOs) whose areas of work are of most interest to you with 1 being your top choice. If you are selected to interview we will use these preferences to schedule your interviewers. Please note that selection of CIOs does not guarantee an interview.

Table 13.5-a. EIS CIO Assignment Interests

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
1^st CDC Centers, Institute, Offices (CIOs):	1. Center for Global Health 2. National Center for Chronic Disease Prevention and Health Promotion 3. National Center for Emerging and Zoonotic Infectious Diseases 4. National Center for Environmental Health/Agency for Toxic Substances and Disease Registry 5. National Center for Health Statistics 6. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 7. National Center for Immunization and Respiratory Diseases 8. National Center for Injury Prevention and Control 9. National Center on Birth Defects and Developmental Disabilities 10. National Institute for Occupational Safety and Health 11. Office of Public Health Preparedness and Response	Yes	No	No	No	No	No	No	No	No	No
2nd CDC Centers, Institute, Offices (CIOs):	1. Center for Global Health 2. National Center for Chronic Disease Prevention and Health Promotion 3. National Center for Emerging and Zoonotic Infectious Diseases 4. National Center for Environmental Health/Agency for Toxic Substances and Disease Registry 5. National Center for Health Statistics 6. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 7. National Center for Immunization and Respiratory Diseases 8. National Center for Injury Prevention and Control 9. National Center on Birth Defects and Developmental Disabilities 10. National Institute for Occupational Safety and Health 11. Office of Public Health Preparedness and Response	Yes	No	No	No	No	No	No	No	No	No
3rd CDC Centers, Institute, Offices (CIOs):	1. Center for Global Health 2. National Center for Chronic Disease Prevention and Health Promotion 3. National Center for Emerging and Zoonotic Infectious Diseases 4. National Center for Environmental Health/Agency for Toxic Substances and Disease Registry 5. National Center for Health Statistics 6. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 7. National Center for Immunization and Respiratory Diseases 8. National Center for Injury Prevention and Control 9. National Center on Birth Defects and Developmental Disabilities 10. National Institute for Occupational Safety and Health 11. Office of Public Health Preparedness and Response	Yes	No	No	No	No	No	No	No	No	No
EIS CIO Assignment Interests	1. Are you applying as a sponsored candidate by a branch of the military? Yes/No. 2. If yes, specify (text box)	Yes	No	No	No	No	No	No	No	No	No
EIS CIO Assignment Interests	By selecting the option below, you confirm that the application information given in this form is true, complete, and accurate.	Yes	No	No	No	No	No	No	No	No	No

INSTRUCTIONAL TEXT

By selecting the option below, you confirm that the application information given in this form is true, complete, and accurate. Three standardized letters of recommendation are required from persons familiar with your academic achievements, aspirations, personal qualities, and professional attributes.

Two of the standardized letters of recommendation must be from persons who are not currently employed at the CDC.

If you are currently employed at CDC, you may request a fourth letter if, in addition to 2 letters from non-CDC employees, you would like to submit 2 letters from current CDC employees.

-Recommenders should typically be current or former supervisors or professors. Avoid requesting letters from colleagues or friends.

-Recommendations must be written in English.

-Let recommenders know you are requesting a recommendation and tell them to expect an email with a link to the online form that they should use to complete the standardized letter of recommendation.

-Traditional narrative letters of recommendation and MSPE (Dean’s letter format) are not accepted.

13.6. Writing Samples

13.6.1 EIS Writing Samples

INSTRUCTIONAL TEXT:

Instructions:

You have 30 minutes to complete this Writing Assessment. The moderator will let you know when 5 minutes and 1 minute remain.

Below is the list of EIS Core Activities of Learning, or CALs, which EIS officers must complete over the course of the fellowship.

EIS Core Activities of Learning (CALs):

CAL 1: Conduct or participate in a field investigation of a potentially serious public health problem that requires a timely response.
CAL 2: Design, conduct, and interpret an epidemiologic analysis
CAL 3: Evaluate a public health surveillance system
CAL 4: Given an in-depth public health talk on the officer’s original work or in their field of study
CAL 5: Give a 5-15 minute oral presentation to a scientific audience
CAL 6: Write a scientific manuscript for a peer-reviewed journal
CAL 7: Write a concise public health update communicating timely information
CAL 8: Write a scientific abstract
CAL 9: Communicate complex scientific concepts to a lay audience
CAL 10: Provide service to the agency (health department or CDC)

Write an email to your supervisor, Dr. Lee, to summarize a professional development goal for the first 6 months of your fellowship. To do this, please select at least one CAL, discuss why you want to focus on this activity, and describe how this activity will help to meet your professional goals.

Table 13.6.1-a. EIS Writing Sample Fields

Field	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Instructional text (writing sample) will change each year. FMS OMB Writing Sample Module includes writing sample options.	Open text response	Yes	No	No	No	No	No	No	No	No	No
I affirm that I have not given or received any unauthorized help on this Writing Assessment, and that this work is my own.		Yes	No	No	No	No	No	No	No	No	No

Match

14.1 Match or Prematch Rank/Rating Form

NEW SECTION 14.1a Interview Form for EIS

Field Name	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Are you planning to attend EIS interviews? You will receive your scheduled interview date by XXX.	1. Yes 2. No	Yes	No	No	No	No	No	No	No	No	No
If no, reason for decline:	Open Text Response	Yes									No
You may be contacted for an EIS interview day. You may be contacted for an EIS interview day. {Interview day information}. Please indicate your top 5 preferred interview dates. Please indicate if you are available for the following interview dates by checking the box. Please select all that apply (at least 5)	Interview Date A Interview Date B Interview Date C Interview Date D Interview Date E etc.	Yes									No
Please provide a phone number where you can be reached on your interview day.	Open Text Response	Yes									No

Table 14.1b General Deferment

Field Name	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
[REASON FOR DEFERMENT] I can no longer participate. Please explain or specify.	Open text response	Yes	Yes	No	Yes	Yes	No	No	No	No	No

Table 14.2 Match or Prematch Rank/Rating Form Fields

Field Name	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Rank:	First Choice - Tenth Choice	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Post Match Rank:	First Choice - Tenth Choice	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Rating:	First Choice - Tenth Choice	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Comments:	Open text response	Yes	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No

Table 14.3 Match or Prematch Rank/Rating Form Fields

Field Name	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
Do you informally accept the tentative match with the assignment indicated above?	1. Accept 2. Decline	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Reason for match decline?	-	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	No
Do you informally accept the tentative prematch with the assignment indicated above?	1. Accept 2. Decline	No	Yes	Yes	No	No	Yes	Yes	No	Yes	No
Reason for pre-match decline?	-	No	Yes	Yes	No	No	Yes	Yes	No	Yes	No

15. Selection Status Acceptance Form

Table 15. Selection Status Acceptance Form

Field Name	Values	EIS	LLS	FLIGHT	EEP	SAF	PHIFP	PE	ELI	PHAP	EFP
1. Do you want to continue with the selection process? 2. Reason for Decline (if decline was selected in #1)	1. Accept 2. Decline	Yes	No	No	No	No	No	No	No	No	No
Do you informally accept the tentative match with the assignment indicated above? (accept/decline)		No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Reason for match decline?	Open Text Response	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Do you informally accept the tentative prematch with the assignment indicated above? (accept/decline)		No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Reason for pre-match decline?	Open Text Response	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	No
Contact Information Confirmation You can view and update your contact information in the EIS Fellowship Application Portal under Applicant Profile. We will be using this information to contact you regarding application status and match. 3.Information about this year’s Prematch sites was sent to you via email.Expressing interest in a Prematch site does not guarantee a Prematch. 4. Are you interested in Prematching? (Yes/No) Please rank your interest in the following prematch sites. Be sure to review the Prematch Position Description information and book sent via email. Dropdown for host sites with response options (0=No Interest; 1=Low Interest; 2=Moderate Interest; 3=High Interest	1. The email listed on my profile form is accurate and accessible for the next 6 months. (Yes) 2. The phone number(s) listed on my profile form are accurate and accessible for the next 6 months. (Yes)	Yes	No	No	No	No	No	No	No	No	No
INSTRUCTIONAL TEXT: Contact Information Confirmation You can view and update your contact information in the EEP Fellowship Application Portal under Applicant Profile. We will be using this information to contact you regarding application status and match.	n/a	No	No	No	Yes	No	No	No	No	No	No
1. The email listed on my profile form is accurate and accessible for the next 6 months.	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No
2. The phone number(s) listed on my profile form are accurate and accessible for the next 6 months.	1. Yes 2. No	No	No	No	Yes	No	No	No	No	No	No

16. EIS Conference Interview Time Selection Form

Table 16. EIS Conference Interview Time Selection Form

Field Name

Values

EIS

LLS

FLIGHT

EEP

SAF

PHIFP

ELI

PHAP

EFP

Host site & Interview Time Slot

[drop down]

Yes

Please select an interview time slot

[drop down]

Yes

Appendix

I. Field Value Tables

Appendix of Field Value Tables

Field Name	Application Locations	Values 1	Values 2	Values 3	Values 4
State Sponsor of Terrorism Country List	6.2 Citizenship Status	See the U.S. Department of State website for current list: https://www.state.gov/j/ct/list/c14151.htm
Approved Country List	6.2 Citizenship Status	United States Anguilla Antigua Australia Bahamas Barbados Barbuda Belize Bermuda British Virgin Islands Canada Dominica Grand Cayman Islands	Grenada Guyana Irish Republic Jamaica Montserrat New Zealand Saint Kitts and Nevis St. Lucia St. Vincent & the Grenadine Tabago Trinidad Turks and Caicos Islands United Kingdom
PHAP Subject Areas	6.8.1 Special Requirements	Adolescent & School Health (non-STI) Community Health Improvement Planning (CHIP)/Community Health Assessments (CHA) Chronic Disease Emergency/Disaster Preparedness and Response Environmental Health Genomics Health Equity/Access to Care Health Department Improvement/Accreditation Immunizations/Vaccine Preventable Disease Investigation Sexually Transmitted Disease Prevention Tuberculosis Prevention HIV Prevention Viral Hepatitis Prevention Adolescent/school-based Sexually Transmitted Disease prevention Other Infectious Disease Injury Prevention Maternal & Infant Health Public Health Policy & Law Public Health Surveillance Oral Health
Undergraduate Degree List	7.7 Degree	AB AM BA BS BS/BA BSc DHS DHSc DNSc DPH DPhil DrPH DrS DrSc EdD MA Med MHS MHSc MHSE MN MPH MPhil MPHTM MPVM MS MSVPH MSc MScPH MSPH MTM&H PhD SB ScB ScD ScM SM Other	Undergraduate Degree List for EEP: AB BA BS BS/BA BSc SB ScB Other
Graduate Degree List	7.7 Degree	AB AM BA BS BS/BA BSc DHS DHSc DNSc DPH DPhil DrPH DrS DrSc EdD MA Med MHS MHSc MHSE MN MPH MPhil MPHTM MPVM MS MSVPH MSc MScPH MSPH MTM&H PhD SB ScB ScD ScM SM Other	Graduate degree list for EEP AM BA DHS DHSc DNSc DPH DPhil DrPH DrS DrSc EdD MA MEd MHS MHSc MHSE MN MPH MPhil MPHTM MPVM MS MSVPH MSc MScPH MSPH MTM&H PhD SB ScB ScD ScM SM Other
Major Classification List	7.7 Degree	Biological, biomedical, or animal sciences Business, management Community health, public health Decision or quantitative sciences Economics (agricultural, applied, health) Engineering, industrial engineering, operations research Environmental, occupational sciences Epidemiology Global, international health Health education Informatics (public health, clinical, nursing) Health services administration, health policy analysis Health services research, quantitative policy analysis Information technology, information science, computer science Liberal arts, general studies, humanities, language, literature Maternal and child health Mathematical sciences, statistics, biostatistics Physical or chemical sciences Political science, law Public administration, policy analysis Social/behavior science (anthropology, social work, psychology) Other
Honor List	7.7 Degree	Magna Cum Laude Summa Cum Laude Cum Laude Valedictorian Benedictorian Salutatorian Phi Beta Kappa Other (specify)
State/Territory List	11.3 Location Preferences 13.3.3 Location Preferences	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington, DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska	Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Pacific Islands U.S. Virgin Islands American Samoa
CDC Fellowship List	11.4 CDC Fellowship Participation	AACN Fellowship AAMC Public Health Policy Fellowship Applied Public Health Informatics Fellowship (APHIF) APTR Preventive Medicine and Public Health Fellowship ASA/NCHS Research Fellowship Program ASM Program in Infectious Disease and Public Health Microbiology ASPH Allan Rosenfield Global Health Fellowship Program ASPPH Public Health Fellowship Program Biochemical Markers Fellowship Collegiate Leaders in Environmental Health (CLEH) CSTE Applied Epidemiology Fellowship Program Dental Public Health Residency DHPE Health Equity Fellowship Program DHPE Internship Program for Public Health Practice Emory Rollins Earn and Learn (REAL) Program E-learning Institute (ELI) Environmental Health Traineeship and Fellowship Program Epidemic Intelligence Service (EIS) Epidemiology Elective Program (EEP) Evaluation Fellowship Federal Work-Study Program (FWS) Field Epidemiology Training Program (FETP) Future Leaders in Infections and Global Health Threats (FLIGHT) Future Public Health Leaders Program (FPHLP) HACU National Internship Program (HNIP) Health Systems Integration Program Hubert Global Health Fellowship Informatics Training in Place Program (I-TIPP) International Emerging Infectious Diseases (IEID) Laboratory Fellowship Program Internships and Externships in Public Health Law James A Ferguson Emerging Infectious Diseases Fellowship Junior Commissioned Officer Student Training and Extern Program (JRCOSTEP) Laboratory Animal Medicine Residency Program (LAMRP) Laboratory Leadership Service (LLS) Maternal Child Health Careers/Research Initiatives for Student Enhancement – Undergraduate Program (MCHC/RISE-UP) Medical Toxicologist Fellowship Program Morehouse College Project IHMOTEP Program National Center for Health Statistics (NCHS) Academy Health Policy Fellowship National Center for Health Statistics (NCHS) Postdoctoral Research Program

II. Lookup Tables

Appendix of Lookup Tables

Lookup Table Name

Application Locations

Values

Fellowship Lookup

3. eFMS System Help Desk Ticket

CDC E-learning Institute Fellowship Program (ELI)

CDC Steven M. Teutsch Prevention Effectiveness (PE) Fellowship

Epidemic Intelligence Service (EIS)

Epidemiology Elective Program (EEP)

Future Leaders in Infections and Global Health Threats (FLIGHT)

Laboratory Leadership Service (LLS)

Population Health Training in Place Program (PH-TIPP)

Population Health Workforce Initiative (PHWI)

Preventive Medicine Residency and Fellowship (PMR/F)

Public Health Associate Program (PHAP)

Public Health Informatics Fellowship Program (PHIFP)

Science Ambassador Fellowship (SAF)

Phone Code Lookup

5.4 Phone Number

United States (1)

Azores (351)

Afghanistan (93)

Albania (355)

Algeria (213)

Andorra (376)

Angola (244)

Anguilla (U.K.) (1)

Antigua and Barbuda (1)

Argentina (54)

Armenia (374)

Aruba (297)

Australia (61)

Austria (43)

Azerbaijan (994)

Bahamas, The (1)

Bahrain (973)

Bangladesh (880)

Barbados (1)

Belarus (375)

Belgium (32)

Belize (501)

Benin (229)

Bermuda (U.K.) (1)

Bhutan (975)

Bolivia (591)

Bosnia and Herzegovina (387)

Botswana (267)

Brazil (55)

British Indian Ocean Territory (U.K.) (246)

Brunei (673)

Bulgaria (359)

Burkina Faso (226)

Burundi (257)

British Virgin Islands (1)

Burma (Myanmar) (95)

Canary Islands (Spain) (34)

Congo, Democratic Republic of the (243)

Congo, Republic of the (242)

Cambodia (855)

Cameroon (237)

Canada (1)

Cape Verde (238)

Cayman Islands (U.K.) (1)

Central African Republic (236)

Chad (235)

Chile (56)

China (86)

Christmas Island (Australia) (61)

Cocos (Keeling) Islands (Australia) (61)

Colombia (57)

Comoros (269)

Cook Islands (New Zealand) (682)

Costa Rica (506)

C?te d'Ivoire (225)

Croatia (385)

Cuba (53)

Cyprus (357)

Czech Republic (420)

Denmark (45)

Djibouti (253)

Dominica (1)

Dominican Republic (1)

Easter Island (Chile) (56)

Ecuador (593)

Egypt (20)

El Salvador (503)

Equatorial Guinea (240)

Eritrea (291)

Estonia (372)

Ethiopia (251)

Falkland Islands (Malvinas) (500)

Faroe Islands (Denmark) (298)

Fiji (679)

Finland (358)

France (33)

French Guiana (France) (594)

French Polynesia (France) (689)

Falkland Islands (U.K.) (500)

Guinea-Bissau (245)

Gabon (241)

Gambia, The (220)

Guyana (592)

Haiti (509)

Georgia (995)

Honduras (504)

Germany (49)

Hong Kong SAR (China) (852)

Ghana (233)

Hungary (36)

Gibraltar (U.K.) (350)

Iceland (354)

Greece (30)

India (91)

Greenland (Denmark) (299)

Indonesia (62)

Grenada (1)

Iran (98)

Guadeloupe (590)

Iraq (964)

Guatemala (502)

Ireland (353)

Guinea (224)

Israel (972)

Italy (39)

Jamaica (1)

Japan (81)

Libya (218)

Jordan (962)

Kazakhstan (7)

Liechtenstein (423)

Kenya (254)

Lithuania (370)

Luxembourg (352)

Kiribati (686)

Macau SAR (China) (853)

Korea, North (850)

Macedonia (389)

Korea, South (82)

Kuwait (965)

Madagascar (261)

Kyrgyzstan (996)

Malawi (265)

Kosovo (381)

Malaysia (60)

Laos (856)

Maldives (960)

Latvia (371)

Mali (223)

Lebanon (961)

Malta (356)

Lesotho (266)

Marshall Islands (692)

Liberia (231)

Martinique (France) (596)

Mauritania (222)

Mauritius (230)

Mayotte (France) (262)

Netherlands, The (31)

Mexico (52)

Micronesia, Federated States of (691)

Netherlands Antilles (599)

Moldova (373)

New Caledonia (France) (687)

Monaco (377)

New Zealand (64)

Mongolia (976)

Nicaragua (505)

Montserrat (U.K.) (1)

Niger (227)

Morocco (212)

Nigeria (234)

Mozambique (258)

Niue (New Zealand) (683)

Madeira Islands (Portugal) (351)

Norfolk Island (Australia) (672)

Montenegro (382)

Northern Mariana Islands (U.S.) (670)

Namibia (264)

Norway (47)

Nauru (674)

Oman (968)

Nepal (977)

Pakistan (92)

Palau (680)

Panama (507)

Papua New Guinea (675)

Paraguay (595)

Peru (51)

Samoa (685)

Philippines (63)

San Marino (378)

Pitcairn Islands (U.K.) (0)

S?o Tom? and Pr?ncipe (239)

Poland (48)

Saudi Arabia (966)

Portugal (351)

Qatar (974)

Senegal (221)

Seychelles (248)

R?union (France) (262)

Romania (40)

Sierra Leone (232)

Russia (7)

Singapore (65)

Rwanda (250)

Slovakia (421)

Saint Kitts and Nevis (1)

Slovenia (386)

Saint Lucia (1)

Solomon Islands (677)

Saint Vincent and the Grenadines (1)

Somalia (252)

South Africa (27)

Spain (34)

Sri Lanka (94)

Sudan (249)

Suriname (597)

Swaziland (268)

Sweden (46)

Tokelau (New Zealand) (690)

Switzerland (41)

Syria (963)

Tonga (676)

Saint Helena (U.K.) (290)

Trinidad and Tobago (1)

Saint Pierre and Miquelon (France) (508)

Serbia (381)

Timor-Leste (East Timor) (670)

Taiwan (886)

Tajikistan (992)

Tanzania (255)

Thailand (66)

Togo (228)

Tunisia (216)

Turkey (90)

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Turks and Caicos Islands (U.K.) (1)

Tuvalu (688)

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Ukraine (380)

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United Kingdom (44)

Yemen (967)

Uruguay (598)

Zambia (260)

Uzbekistan (998)

Zimbabwe (263)

Vanuatu (678)

Other (0)

Country Lookup

5.5 Mailing Address

6.2 Citizenship Status

6.10.2 Program & Organization

8.6 Position Location

9.6 Institution Details and Location

United States

Afghanistan

Albania

Algeria

Andorra

Angola

Anguilla (U.K.)

Antigua and Barbuda

Argentina

Armenia

Aruba

Australia

Austria

Azerbaijan

Azores

Bahamas, The

Bahrain

Bangladesh

Barbados

Belarus

Belgium

Belize

Benin

Bermuda (U.K.)

Bhutan

Bolivia

Bosnia and Herzegovina

Botswana

Brazil

British Indian Ocean Territory (U.K.)

British Virgin Islands

Brunei

Bulgaria

Burkina Faso

Burma (Myanmar)

Burundi

Cambodia

Cameroon

Canada

Canary Islands (Spain)

Cape Verde

Cayman Islands (U.K.)

Central African Republic

China

Chad

Christmas Island (Australia)

Chile

Cocos (Keeling) Islands (Australia)

Colombia

Comoros

Congo, Democratic Republic of the

Congo, Republic of the

Cook Islands (New Zealand)

Costa Rica

Cote d'Ivoire

Djibouti

Croatia

Cuba

Dominica

Cyprus

Dominican Republic

Czech Republic

Easter Island (Chile)

Denmark

Ecuador

Egypt

El Salvador

Equatorial Guinea

Eritrea

Estonia

Ethiopia

Falkland Islands (Malvinas)

Finland

Falkland Islands (U.K.)

Faroe Islands (Denmark)

France

Fiji

French Guiana (France)

French Polynesia (France)

Gabon

Gambia, The

Georgia

Germany

Ghana

Gibraltar (U.K.)

Greece

Guinea

Greenland (Denmark)

Grenada

Guinea-Bissau

Guadeloupe

Guyana

Guatemala

Haiti

Honduras

Hong Kong SAR (China)

Hungary

Iceland

India

Indonesia

Iran

Jamaica

Iraq

Japan

Ireland

Jordan

Israel

Kazakhstan

Italy

Kenya

Kiribati

Korea, North

Korea, South

Kosovo

Kuwait

Kyrgyzstan

Laos

Liberia

Latvia

Libya

Lebanon

Liechtenstein

Lesotho

Lithuania

Luxembourg

Macau SAR (China)

Macedonia

Madagascar

Madeira Islands (Portugal)

Malawi

Malaysia

Martinique (France)

Maldives

Mauritania

Mali

Mauritius

Malta

Mayotte (France)

Marshall Islands

Mexico

Moldova

Monaco

Mongolia

Montenegro

Montserrat (U.K.)

Morocco

Mozambique

Netherlands Antilles

Namibia

Nauru

Netherlands, The

Nepal

New Caledonia (France)

New Zealand

Nicaragua

Niger

Nigeria

Niue (New Zealand)

Northfolk Island (Australia)

Northern Mariana Islands (U.S.)

Panama

Norway

Papua New Guinea

Oman

Paraguay

Other

Peru

Pakistan

Philippines

Palau

Pitcairn Islands (U.K.)

Poland

Portugal

Qatar

Reunion (France)

Romania

Russia

Rwanda

Saint Lucia

Saint Helena (U.K.)

Saint Pierre and Miquelon (France)

Saint Kitts and Nevis

Saint Vincent and the Grenadines

Samoa

San Marino

Sao Tome and Principe

Saudi Arabia

Senegal

Serbia

Seychelles

Somalia

Sierra Leone

Singapore

South Africa

Slovakia

Spain

Slovenia

Sri Lanka

Solomon Islands

Sudan

Suriname

Swaziland

Sweden

Switzerland

Syria

Taiwan

Tajikistan

Tanzania

Togo

Thailand

Timor-Leste (East Timor)

Tokelau (New Zealand)

Tonga

Trinidad and Tobago

Tunisia

Turkey

Turkmenistan

Turks and Caicos Islands (U.K.)

Tuvalu

Vanuatu

Uganda

Venezuela

Ukraine

Vietnam

United Arab Emirates

Western Sahara

United Kingdom

Yemen

Uruguay

Zambia

Uzbekistan

Zimbabwe

State/Territory Lookup

5.5 Mailing Address

6.8.1 Special Requirements

6.10.2 Program & Organization

7.9 License

8.6 Position Location

9.6 Institution Details and Location

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

Washington, DC

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

Puerto Rico

Pacific Islands

U.S. Virgin Islands

Guam

Northern Mariana Islands

Center/Division/Branch Lookup

6.9.2 FLIGHT – Current EIS Position

6.10.2 Program & Organization

NIOSH / Office of the Director / Administrative Svcs Branch (Cincinnati)

NIOSH / Office of the Director / Administrative Svcs Branch (Morgantown)

NIOSH / Office of the Director / Administrative Svcs Branch (Spokane)

NIOSH / Office of the Director / Administrative Svrcs Branch (Pittsburgh)

NCHS / Office of Analysis & Epidemiology / Aging & Chronic Disease Statistics Branch

NIOSH / Health Effects Laboratory Division / Allergy & Clinical Immunology Branch

NCHS / Division of Health Care Statistics / Ambulatory and Hospital Care Statistics Branch

NIOSH / Division of Safety Research / Analysis & Field Branch

NCHS / Division of Health & Nutrition Examination Surveys / Analysis Branch

NCHS / Office of Analysis & Epidemiology / Analytic Studies Branch

NCEZID / Division of Scientific Resources / Animal Resources Branch

NCCDPHP / Division for Heart Disease and Stroke Prevention / Applied Research and Evaluation Branch

NCCDPHP / Division of Population Health / Applied Research and Translation Branch

CPR / Division of State and Local Readiness / Applied Science and Evaluation Branch

NCCDPHP / Division of Reproductive Health / Applied Sciences Branch

NCEZID / Division of Vector-Borne Diseases / Arboviral Diseases Branch

NCEZID / Division of Preparedness and Emerging Infections / Arctic Investigations Program

NCCDPHP / Division of Population Health / Arthritis, Epilepsy and Well-Being Branch

NCIRD / Immunization Services Division / Assessment Branch

NCEH / Division of Environmental Health Science and Practice / Asthma and Community Health Branch

NCEZID / Division of Vector-Borne Diseases / Bacterial Diseases Branch

NCEZID / Division of High Consequence Pathogens & Pathology / Bacterial Special Pathogens Branch

NCHHSTP / Division of HIV/AIDS Prevention Surveillance & Epidemiology / Behavioral And Clinical S...

NIOSH / Division of Applied Research & Technology / Biomonitoring & Health Assessment Branch

NIOSH / Health Effects Laboratory Division / Biostatistics & Epidemiology Branch

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Biostatistics and Informa...

NCEZID / Division of Scientific Resources / Biotechnology Core Facility Branch

NCBDDD / Division of Congenital and Developmental Disorders / Birth Defects Branch

NCHS / Office of Management & Operations / Building Operations & Services Staff

NCHS / Office of Management & Operations / Business Logistics Staff

NCCDPHP / Division of Cancer Prevention and Control / Cancer Surveillance Branch

NCHHSTP / Division of HIV/AIDS Prevention-Intervention & Support / Capacity Building Branch

CPR / Division of State and Local Readiness / Capacity Building Branch

ATSDR / Division of Community Health Investigations / Central Branch

NIOSH / Division of Applied Research & Technology / Chemical Exposure & Monitoring

NCBDDD / Division of Human Development and Disability / Child Development and Disability Branch

NCEZID / Division of High Consequence Pathogens & Pathology / Chronic Viral Diseases Branch

NCHS / Classification & Public Health Data Standards Staff / Classification & Public Health Data ...

NCEZID / Division of Healthcare Quality Promotion / Clinical & Environmental Microbiology Branch

NCEH / Division of Laboratory Science / Clinical chemistry branch

NCHHSTP / Division of Tuberculosis Elimination / Clinical Research Branch

NCHS / Division of Research & Methodology / Collaborating Center for Questionnaire Design & Evalu...

NCHS / Division of Research & Methodology / Collaborating Center for Statistical Research & Surve...

NCIRD / Immunization Services Division / Communication and Education Branch

NCHHSTP / Division of Tuberculosis Elimination / Communications, Education, and Behavioral Studie...

CSELS / Division of Public Health Information and Dissemination / Community Guide Branch

NCCDPHP / Division of Cancer Prevention and Control / Comprehensive Cancer Control Branch

ATSDR / Division of Toxicology and Human Health Sciences / Computational Toxicology and Methods D...

NIOSH / Education & Information Division / Document Development Branch

NIOSH / National Personal Protective Technology Laboratory / Conformity Verification & Standards ...

NCCDPHP / Division of Population Health / Coordinated State Support Branch

NIOSH / Pittsburgh Mining Research Division / Dust, Ventilation & Toxic Substances Branch

CGH / Division of Global Health Protection / Country Strategy and Implementation Branch

ATSDR / Division of Community Health Investigations / Eastern Branch

NCHS / Division of Vital Statistics / Data Acquisition, Classification & Evaluation Branch

CGH / Division of Global HIV and TB / Economics and Health Services Research Branch

NCHS / Division of Health Interview Statistics / Data Analysis & Quality Assurance Branch

CSELS / Division of Scientific Education and Professional Development / Education and Training Se...

NCHHSTP / Division of Tuberculosis Elimination / Data Management and Statistics Branch

NIOSH / Pittsburgh Mining Research Division / Electrical & Mechanical Systems Safety Branch

NCHS / Division of Health Interview Statistics / Data Production & Systems Branch

CPR / Division of Emergency Operations / Emergency and Risk Communications Branch

NCEZID / Division of Vector-Borne Diseases / Dengue Branch

NCEH / Division of Environmental Health Science and Practice / Emergency Management, Radiation, a...

NCBDDD / Division of Congenital and Developmental Disorders / Developmental Disabilities Branch

NCEZID / Division of Preparedness and Emerging Infections / Emergency Preparedness and Response B...

NCBDDD / Division of Human Development and Disability / Disability and Health Branch

CGH / Division of Global Health Protection / Emergency Response and Recovery Branch

NIOSH / Division of Compensation Analysis & Support / Division of Compensation Analysis & Support

NCEH / Division of Laboratory Science / Emergency response branch

NCCDPHP / Division of Oral Health / Division of Oral Health

ATSDR / Division of Toxicology and Human Health Sciences / Emergency Response Program

NIOSH / Health Effects Laboratory Division / Engineering & Control Branch

NIOSH / Division of Applied Research & Technology / Engineering & Physical Hazards Branch

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Enteric Diseases Epidemio...

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Enteric Diseases Laborato...

CGH / Division of Parasitic Diseases and Malaria / Entomology Branch

ATSDR / Division of Toxicology and Human Health Sciences / Environmental Epidemiology Branch

NCCDPHP / Division of Population Health / Epidemiology and Surveillance Branch

NCEH / Division of Emergency and Environmental Health Services / Environmental Health Services Br...

ATSDR / Division of Toxicology and Human Health Sciences / Environmental Health Surveillance Branch

NCHHSTP / Division of Viral Hepatitis / Epidemiology and Surveillance Branch

ATSDR / Division of Toxicology and Human Health Sciences / Environmental Medicine Branch

NCHHSTP / Division of HIV/AIDS Prevention Surveillance & Epidemiology / Epidemiology Branch

NCEH / Division of Emergency and Environmental Health Services / Environmental Public Health Read...

NCCDPHP / Office on Smoking and Health / Epidemiology Branch

ATSDR / Division of Toxicology and Human Health Sciences / Environmental Toxicology Branch

NCEZID / Division of Healthcare Quality Promotion / Epidemiology Research and Innovations Branch

NCCDPHP / Division of Cancer Prevention and Control / Epidemiology and Applied Research Branch

CSELS / Division of Scientific Education and Professional Development / Epidemiology Workforce Br...

NCIRD / Influenza Division / Epidemiology and Prevention Branch

CGH / Division of Global Health Protection / Epidemiology, Informatics, Surveillance and Lab Branch

NCCDPHP / Division of Diabetes Translation / Epidemiology and Statistics Branch

NIOSH / National Personal Protective Technology Laboratory / Evaluation & Testing Branch

NCHHSTP / Division of Sexually Transmitted Disease Prevention / Epidemiology and Statistics Branch

NIOSH / Health Effects Laboratory Division / Exposure Assessment Branch

NCCDPHP / Division for Heart Disease and Stroke Prevention / Epidemiology and Surveillance Branch

NCHHSTP / Division of Sexually Transmitted Disease Prevention / Field Services Branch

NCBDDD / Division of Blood Disorders / Epidemiology and Surveillance Branch

CPR / Division of State and Local Readiness / Field Services Branch

CGH / Division of Global HIV and TB / Epidemiology and Surveillance Branch

NCHHSTP / Division of Tuberculosis Elimination / Field Services Branch

NIOSH / Respiratory Health Division / Field Studies Branch

NCCDPHP / Division of Reproductive Health / Field Support Branch

NIOSH / Pittsburgh Mining Research Division / Fires and Explosions Branch

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Food Safety Office

NCEZID / Division of Global Migration and Quarantine / Geographic Medicine and Health Promotion B...

NCHS / Office of Analysis & Epidemiology / Health Promotion Statistics Branch

ATSDR / Division of Toxicology and Human Health Sciences / Geospatial Research, Analysis, and Ser...

CGH / Division of Global Health Protection / Global Non-communicable Disease Branch

NCCDPHP / Office on Smoking and Health / Global Tobacco Control Branch

NCHHSTP / Division of Sexually Transmitted Disease Prevention / Health Services Research and Eval...

CGH / Division of Global HIV and TB / Global Tuberculosis Branch

NCIPC / Division of Unintentional Injury Prevention / Health Systems and Trauma Systems Branch

NIOSH / Pittsburgh Mining Research Division / Ground Control Branch

NCEH / Division of Emergency and Environmental Health Services / Healthy Community Design Initiative

NIOSH / Division of Surveillance, Hazard Evaluations & Field Studies / Hazard Evaluations & Techn...

NCEH / Division of Emergency and Environmental Health Services / Healthy Homes and Lead Poisoning...

NIOSH / Health Effects Laboratory Division / Health Communication Research Branch

NCBDDD / Division of Blood Disorders / Hemostasis Laboratory Branch

NCCDPHP / Office of the Director / Health Communication Science Office

NCHHSTP / Office of the Director / Health Communication Science Office

CGH / Division of Global HIV and TB / HIV Care and Treatment Branch

NCBDDD / Office of the Director / Health Communication Science Office

NCHHSTP / Division of HIV/AIDS Prevention Surveillance & Epidemiology / HIV Incidence and Case Su...

NIOSH / Pittsburgh Mining Research Division / Health Communication, Surveillance, Research Suppor...

CGH / Division of Global HIV and TB / HIV Prevention Branch

NCCDPHP / Office on Smoking and Health / Health Communications Branch

NCIPC / Division of Unintentional Injury Prevention / Home, Recreation, and Transportation Branch

CGH / Division of Global HIV and TB / Health Informatics, Data Management, and Statistics Branch

NIOSH / Pittsburgh Mining Research Division / Human Factors Branch

NCEZID / Division of Global Migration and Quarantine / Immigrant, Refugee, and Migrant Health Branch

NCIRD / Immunization Services Division / Immunization Information System Support Branch

NCEZID / Division of Healthcare Quality Promotion / Immunization Safety Office

CGH / Global Immunization Division / Immunization System Branch

NCIRD / Influenza Division / Immunology and Pathogenesis Branch

NIOSH / Division of Surveillance, Hazard Evaluations & Field Studies / Industrywide Studies Branch

NCHS / Office of Analysis & Epidemiology / Infant, Child, & Women?s Health Statistics Branch

NCEZID / Division of High Consequence Pathogens & Pathology / Infectious Diseases Pathology Branch

NCIRD / Office of the Director / Influenza Coordination Unit

CGH / Division of Global HIV and TB / International Laboratory Branch

NCHS / Division of Health & Nutrition Examination Surveys / Informatics Branch

CSELS / Division of Public Health Information and Dissemination / Informatics Innovation Unit

NCHHSTP / Division of HIV/AIDS Prevention Surveillance & Epidemiology / Laboratory Branch

NCHHSTP / Office of the Director / Informatics Office

NCHHSTP / Division of Tuberculosis Elimination / Laboratory Branch

NCHS / Office of Information Services / Information Design & Publishing Staff

NCHHSTP / Division of Viral Hepatitis / Laboratory Branch

NCHS / Office of Information Services / Information Dissemination Staff

NIOSH / Education & Information Division / Information Resources and Dissemination Branch

CSELS / Division of Laboratory Systems / Laboratory Practice Standards Branch

NCEZID / Division of Preparedness and Emerging Infections / Laboratory Preparedness and Response ...

CSELS / Division of Health Informatics and Surveillance Systems / Information Systems Branch

NCHHSTP / Division of Sexually Transmitted Disease Prevention / Laboratory Reference and Research...

NCHS / Division of Vital Statistics / Information Technology Branch

NCHS / Office of Information Technology / Information Technology Solutions & Services Staff

CSELS / Division of Laboratory Systems / Laboratory

Research and Evaluation Branch

NCEH / Division of Laboratory Science / Inorganic and radiation analytical toxicology branch

CSELS / Division of Laboratory Systems / Laboratory Training and Services Branch

NCEH / Division of Environmental Health Science and Practice / Lead Poisoning Prevention and Envi...

CSELS / Division of Public Health Information and Dissemination / Library Science Branch

CPR / Division of Strategic National Stockpile / Logistics Branch

CPR / Division of Emergency Operations / Logistics Support Branch

NCHS / Division of Health Care Statistics / Long-Term Care Statistics Branch

CGH / Division of Parasitic Diseases and Malaria / Malaria Branch

CGH / Division of Global HIV and TB / Management and Operations Branch

NIOSH / Office of the Director / Management Systems Branch

CGH / Division of Global HIV and TB / Maternal and Child Health Branch

NCCDPHP / Division of Reproductive Health / Maternal and Infant Health Branch

NCIRD / Division of Bacterial Branch / Meningitis and Vaccine Preventable Diseases Branch

CGH / Division of Global HIV and TB / Monitoring, Evaluation, and Data Analysis Branch

NIOSH / Office of the Director / Office of Extramural Coordination & Special Projects

NCHS / Division of Vital Statistics / Mortality Statistics Branch

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Mycotic Diseases Branch

NCEH / Office of the Director / Office of Financial, Administrative, and Information Services

NCEH / Division of Laboratory Science / Newborn screening and molecular biology branch

NCIRD / Office of the Director / Office of Health Communication Science

NCCDPHP / Division of Nutrition, Physical Activity, & Obesity / Nutrition Branch

NCHHSTP / Office of the Director / Office of Health Equity

NCEH / Division of Laboratory Science / Nutritional biomarkers branch

NCIRD / Office of the Director / Office of Informatics

NCCDPHP / Division of Nutrition, Physical Activity, & Obesity / Obesity Prevention and Control Br...

NCIRD / Office of the Director / Office of Laboratory Science

NIOSH / Office of the Director / Office of Administrative & Management Svcs

NCIRD / Office of the Director / Office of Management and Operations

NCEH / Office of the Director / Office of Communication

NCHHSTP / Office of the Director / Office of Management and Program Support

NCIPC / Office of the Director / Office of Communication

NCHS / Office of Planning Budget and Legislation / Office of Planning Budget and Legislation

NCIRD / Office of the Director / Office of Policy

NCIPC / Office of the Director / Office of Policy and Partnerships

NCEH / Office of the Director / Office of Policy, Planning, and Evaluation

NCIPC / Office of the Director / Office of Program Management and Operations

NCHHSTP / Office of the Director / Office of Program Planning & Policy Coordination

CSELS / Division of Public Health Information and Dissemination / Office of Public Health Genomics

NCCDPHP / Office of the Director / Office of Public Health Practice

NCIRD / Office of the Director / Office of Science and Integrated Programs

NCHHSTP / Office of the Director / Office of the Associate Director for Laboratory Science

NCHHSTP / Office of the Director / Office of the Associate Director for Science

NCIPC / Office of the Director / Office of the Associate Director for Science

NCHS / Office of the Director / Office of the Director

NCHS / Division of Health & Nutrition Examination Surveys / Office of the Director

NCHS / Division of Health Care Statistics / Office of the Director

CPR / Office of the Director / Office of the Director

NCHS / Division of Health Interview Statistics / Office of the Director

NCEZID / Division of Healthcare Quality Promotion / Office of the Director/International Infectio...

NCCDPHP / Division of Reproductive Health / Office of the Director

NCCDPHP / Division of Cancer Prevention and Control / Office of the Director/Office of Internatio...

NCHS / Division of Vital Statistics / Office of the Director

NCEZID / Office of the Director / One Health Office

NCHS / Office of Analysis & Epidemiology / Office of the Director

CPR / Division of Emergency Operations / Operations Branch

CGH / Office of the Director / Office of the Director

NCHS / Division of Health & Nutrition Examination Surveys / Operations Branch

CSELS / Office of the Director / Office of the Director

CPR / Division of Select Agents and Toxins / Operations Branch

NCEZID / Office of the Director / Office of the Director

NCEH / Division of Laboratory Science / Organic analytical toxicology branch

NCHS / Office of the Director / Office of the Director

NIOSH / Division of Applied Research & Technology / Organizational Science & Human Factors Branch

NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Outbreak Response and Pre...

CGH / Division of Global Health Protection / Overseas Business Operations Branch

CGH / Division of Global HIV and TB / Overseas Strategy and Management Branch

CGH / Division of Parasitic Diseases and Malaria / Parasitic Diseases Branch

CSELS / Division of Health Informatics and Surveillance Systems / Partnerships and Evaluation Branch

NIOSH / Health Effects Laboratory Division / Pathology & Physiological Research Branch

NCCDPHP / Division of Nutrition, Physical Activity, & Obesity / Physical Activity and Health Branch

CPR / Division of Strategic National Stockpile / Planning and Analysis Branch

NCHS / Division of Health & Nutrition Examination Surveys / Planning Branch

CPR / Division of Emergency Operations / Plans, Training, Exercise and Evaluation Branch

NCIPC / Division of Violence Prevention / Prevention Practice and Translation Branch

NCBDDD / Office of the Director / Policy, Planning, and Evaluation Team

NCHHSTP / Division of HIV/AIDS Prevention-Intervention & Support / Prevention Program Branch

NCIRD / Division of Viral Diseases / Polio and Picornavirus Laboratory Branch

NCBDDD / Division of Congenital and Developmental Disorders / Prevention Research and Translation...

CGH / Global Immunization Division / Polio Eradication

NCCDPHP / Division of Population Health / Population Health Surveillance Branch

NCHHSTP / Division of HIV/AIDS Prevention-Intervention & Support / Prevention Research Branch

CSELS / Division of Scientific Education and Professional Development / Population Health Workfor...

NCEZID / Division of High Consequence Pathogens & Pathology / Prion & Public Health Office

NCEZID / Division of High Consequence Pathogens & Pathology / Poxvirus and Rabies Branch

NCHHSTP / Office of the Director / Program and Performance Improvement Office

NCIPC / Division of Analysis, Research, and Practice Integration / Practice Integration and Evalu...

CGH / Division of Global HIV and TB / Program Budget and Extramural Management Branch

NCEZID / Division of Healthcare Quality Promotion / Prevention & Response Branch

NCCDPHP / Division of Nutrition, Physical Activity, & Obesity / Program Development and Evaluatio...

NCHHSTP / Division of Viral Hepatitis / Prevention Branch

NCCDPHP / Division for Heart Disease and Stroke Prevention / Program Development and Services Branch

NCHHSTP / Division of HIV/AIDS Prevention-Intervention & Support / Prevention Communications Branch

NCHHSTP / Division of Adolescent and School Health / Program Development and Services Branch

NCHHSTP / Division of HIV/AIDS Prevention-Intervention & Support / Program Evaluation Branch

NCCDPHP / Division of Diabetes Translation / Program Implementation Branch

CPR / Division of Select Agents and Toxins / Program Management and Operations Branch

NCIRD / Immunization Services Division / Program Operations Branch

NCCDPHP / Division of Cancer Prevention and Control / Program Services Branch

CPR / Division of Select Agents and Toxins / Program Services Branch

CPR / Division of State and Local Readiness / Program Services Branch

NCCDPHP / Office of the Director / Program Services Branch

NCCDPHP / Office on Smoking and Health / Program Services Branch

NCHHSTP / Division of Sexually Transmitted Disease Prevention / Programs Development and Quality ...

NIOSH / Division of Safety Research / Protective Technology Branch

NCIRD / Division of Viral Diseases / Respiratory Viruses Branch

NCHHSTP / Division of HIV/AIDS Prevention Surveillance & Epidemiology / Quantitative Sciences and...

NCEZID / Division of Global Migration and Quarantine / Quarantine and Border Health Services Branch

CPR / Division of Strategic National Stockpile / Response Branch

NCHS / Division of Vital Statistics / Reproductive Statistics Branch

NCEZID / Division of Vector-Borne Diseases / Rickettsial Zoonoses Branch

NCIPC / Division of Violence Prevention / Research and Evaluation Branch

NIOSH / Education & Information Division / Risk Evaluation Branch

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NCIPC / Division of Violence Prevention / Special Surveys & Prevention Initiatives Branch (proposed)

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NIOSH / Spokane Mining Research Division / Spokane Mining Research Division

NIOSH / Division of Surveillance, Hazard Evaluations & Field Studies / Statistical Support Most E...

NCIPC / Division of Analysis, Research, and Practice Integration / Statistics, Programming, and E...

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NCEZID / Division of Foodborne, Waterborne and Environmental Diseases / Waterborne Diseases Preve...

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CGH / Division of Global Health Protection / Workforce and Institute Development Branch

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Macalester College - Minnesota

Martin Luther College - Minnesota

Metropolitan State University - Minnesota

Minneapolis College of Art & Design - Minnesota

Minnesota State University, Mankato - Minnesota

Minnesota State University, Moorhead - Minnesota

North Central University - Minnesota

Northwestern College - Minnesota

Oak Hills Christian College - Minnesota

Walden University - Minnesota

Pillsbury Baptist Bible College - Minnesota

William Mitchell College of Law - Minnesota

Saint John's University - Minnesota

Winona State University - Minnesota

Saint Mary's University of Minnesota - Minnesota

Alcorn State University - Mississippi

Saint Olaf College - Minnesota

Belhaven College - Mississippi

Southwest Minnesota State University - Minnesota

Blue Mountain College - Mississippi

St. Cloud State University - Minnesota

Delta State University - Mississippi

University of Minnesota, Crookston - Minnesota

Jackson State University - Mississippi

University of Minnesota, Duluth - Minnesota

Magnolia Bible College - Mississippi

University of Minnesota, Morris - Minnesota

Millsaps College - Mississippi

University of Minnesota, Twin Cities - Minnesota

Mississippi College - Mississippi

University of Saint Thomas - Minnesota

Mississippi State University - Mississippi

Mississippi University for Women - Mississippi

Mississippi Valley State University - Mississippi

Rust College - Mississippi

Tougaloo College - Mississippi

University of Mississippi - Mississippi

University of Mississippi Medical Center - Mississippi

University of Southern Mississippi - Mississippi

William Carey College - Mississippi

A.T. Still University of Health Sciences - Missouri

Columbia College - Missouri

Avila College - Missouri

Baptist Bible College - Missouri

Concordia Seminary-St. Louis - Missouri

Calvary Bible College & Theological Seminary - Missouri

Culver-Stockton College - Missouri

Central Bible College - Missouri

DeVry University-Kansas City - Missouri

Central Christian College of the Bible - Missouri

Drury University - Missouri

Central Methodist University - Missouri

Evangel University - Missouri

Central Missouri State University - Missouri

Fontbonne University - Missouri

Cleveland Chiropractic College - Missouri

Forest Institute of Professional Psychology - Missouri

College of the Ozarks - Missouri

Greenleaf University - Missouri

Hannibal-Lagrange College - Missouri

Harris-Stowe State University - Missouri

Lincoln University - Missouri

Lindenwood University - Missouri

Logan College of Chiropractic - Missouri

Maryville University of St. Louis - Missouri

Missouri Baptist College - Missouri

Missouri Southern State University - Missouri

Missouri State University - Missouri

Missouri Valley College - Missouri

Missouri Western State University - Missouri

Northwest Missouri State University - Missouri

Ozark Christian College - Missouri

Park University - Missouri

Rockhurst University - Missouri

Saint Louis University - Missouri

University of Missouri, Columbia - Missouri

Southeast Missouri State University - Missouri

Southwest Baptist University - Missouri

University of Missouri, Kansas City - Missouri

St. Louis College of Pharmacy - Missouri

University of Missouri, Rolla - Missouri

Stephens College - Missouri

University of Missouri, St. Louis - Missouri

Truman State University - Missouri

Washington University in St. Louis - Missouri

Webster University - Missouri

Westminster College - Missouri

William Jewell College - Missouri

William Woods University - Missouri

Carroll College - Montana

Montana State University, Billings - Montana

Salish Kootenai College - Montana

Montana State University, Bozeman - Montana

Montana State University, Northern - Montana

University of Great Falls - Montana

University of Montana, Missoula - Montana

Montana Tech - Montana

University of Montana, Western - Montana

Rocky Mountain College - Montana

Bellevue University - Nebraska

Chadron State College - Nebraska

Clarkson College - Nebraska

College of Saint Mary - Nebraska

Concordia University-Nebraska - Nebraska

Creighton University - Nebraska

Dana College - Nebraska

Doane College - Nebraska

Nebraska Christian College - Nebraska

Grace University - Nebraska

Hastings College - Nebraska

Midland Lutheran College - Nebraska

Nebraska Methodist College - Nebraska

Nebraska Wesleyan University - Nebraska

Peru State College - Nebraska

Union College - Nebraska

University of Nebraska, Kearney - Nebraska

University of Nebraska, Lincoln - Nebraska

University of Nebraska, Medical Center - Nebraska

University of Nebraska, Omaha - Nebraska

Wayne State College - Nebraska

York College - Nebraska

Chester College of New England - New Hampshire

Great Basin College - Nevada

Sierra Nevada College - Nevada

Colby-Sawyer College - New Hampshire

University of Nevada - Nevada

Daniel Webster College - New Hampshire

Antioch New England - New Hampshire

Dartmouth College - New Hampshire

Franklin Pierce College - New Hampshire

Franklin Pierce Law Center - New Hampshire

Granite State College - New Hampshire

Keene State College - New Hampshire

New England College - New Hampshire

Plymouth State College - New Hampshire

Rivier College - New Hampshire

Saint Anselm College - New Hampshire

Southern New Hampshire University - New Hampshire

The Thomas More College of Liberal Arts - New Hampshire

University of New Hampshire at Manchester - New Hampshire

University of New Hampshire - New Hampshire

Berkeley College - New Jersey

Bloomfield College - New Jersey

Caldwell College - New Jersey

Centenary College - New Jersey

College of Saint Elizabeth - New Jersey

Drew University - New Jersey

Fairleigh Dickinson University - New Jersey

Felician College - New Jersey

Georgian Court College - New Jersey

Kean University - New Jersey

Princeton University - New Jersey

Monmouth University - New Jersey

Ramapo College - New Jersey

Montclair State University - New Jersey

Richard Stockton College of New Jersey - New Jersey

New Jersey City University - New Jersey

Rider University - New Jersey

Rowan University - New Jersey

New Jersey Institute of Technology - New Jersey

Rutgers University, Camden - New Jersey

Rutgers University, New Brunswick/Piscataway - New Jersey

Rutgers University, Newark - New Jersey

Saint Peter's College - New Jersey

Seton Hall University - New Jersey

Stevens Institute of Technology - New Jersey

The College of New Jersey - New Jersey

Thomas Edison State College - New Jersey

College of Santa Fe - New Mexico

University of Medicine & Dentistry of New Jersey - New Jersey

College of the Southwest - New Mexico

William Paterson University - New Jersey

Eastern New Mexico University - New Mexico

Institute of American Indian Arts - New Mexico

New Mexico Highlands University - New Mexico

New Mexico Institute of Mining & Technology - New Mexico

New Mexico State University - New Mexico

Southwestern College - New Mexico

St. John's College-Santa Fe - New Mexico

University of New Mexico - New Mexico

Western New Mexico University - New Mexico

Adelphi University - New York

Albany College of Pharmacy - New York

Albany Medical College - New York

Alfred University - New York

Arnold & Marie Schwartz College of Pharmacy & Health Sciences - New York

Cazenovia College - New York

Bank Street College of Education - New York

City College - New York

Bard College - New York

Clarkson University - New York

Barnard College - New York

Colgate University - New York

Baruch College - New York

College at Brockport - New York

Boricua College - New York

College at Buffalo (Buffalo State College) - New York

Brooklyn College - New York

College at Cortland - New York

Canisius College - New York

College at Fredonia - New York

College at Geneseo - New York

College at New Paltz - New York

College at Old Westbury - New York

College at Oneonta - New York

College at Oswego - New York

College at Plattsburgh - New York

College at Potsdam - New York

College at Purchase - New York

College of Agriculture & Technology at Cobleskill - New York

College of Agriculture & Technology at Morrisville (Morrisville State College) - New York

College of Environmental Science & Forestry - New York

College of Mount St. Vincent - New York

College of New Rochelle - New York

College of Optometry - New York

College of Saint Rose - New York

Cornell University - New York

College of Staten Island - New York

Culinary Institute of America - New York

College of Technology at Alfred (Alfred State University) - New York

D'Youville College - New York

College of Technology at Canton - New York

Daemen College - New York

College of Technology at Delhi - New York

Davis College - New York

College of Technology at Farmingdale (Farmingdale State University) - New York

Dominican College - New York

Columbia University - New York

Dowling College - New York

Concordia College-Bronxville - New York

Downstate Medical Center - New York

Elmira College - New York

Empire State College - New York

Excelsior College - New York

Fashion Institute of Technology - New York

Five Towns College - New York

Fordham University - New York

Graduate School & University Center - New York

Hamilton College - New York

Hartwick College - New York

Hebrew Union College-Jewish Institute of Religion - New York

Hilbert College - New York

Hobart and William Smith Colleges - New York

Lehman College - New York

Hofstra University - New York

Long Island University, Brentwood Campus - New York

Houghton College - New York

Hunter College - New York

Long Island University, Brooklyn Campus - New York

Institute of Technology at Utica/Rome - New York

Long Island University, C.W. Post Campus - New York

Iona College - New York

Long Island University, Rockland Graduate Campus - New York

Ithaca College - New York

Long Island University, Southampton Graduate Campus - New York

John Jay College of Criminal Justice - New York

Long Island University, Westchester Graduate Campus - New York

Keuka College - New York

Manhattan College - New York

Laboratory Institute of Merchandising - New York

Manhattan School of Music - New York

Le Moyne College - New York

Manhattanville College - New York

Marist College - New York

Maritime College at Ft. Schuyler - New York

Marymount College - New York

Marymount Manhattan College - New York

Medaille College - New York

Medger Evers College - New York

Mercy College - New York

Metropolitan College of New York - New York

Molloy College - New York

Monroe College - New York

Pace University - New York

Mount Saint Mary College - New York

Nazareth College - New York

Parsons School of Design - New York

New School University - New York

Paul Smith's College - New York

Polytechnic University of New York - New York

New York City College of Technology - New York

Pratt Institute - New York

Queens College - New York

New York College of Podiatric Medicine - New York

Rensselaer Polytechnic Institute - New York

New York Institute of Technology - New York

Roberts Wesleyan College - New York

New York Medical College - New York

Rochester Institute of Technology - New York

New York University - New York

Saint Francis College - New York

Niagara University - New York

Sarah Lawrence College - New York

Nyack College - New York

School of Visual Arts - New York

Siena College - New York

Skidmore College - New York

St. Bonaventure University - New York

St. John Fisher College - New York

St. John's University - New York

St. Joseph's College - New York

The Sage Colleges - New York

St. Lawrence University - New York

Touro College - New York

St. Thomas Aquinas College - New York

Unification Theological Seminary - New York

State University of New York, Albany - New York

Union College - New York

State University of New York, Binghamton - New York

Union Theological Seminary - New York

State University of New York, Buffalo - New York

United States Merchant Marine Academy - New York

State University of New York, Stony Brook - New York

United States Military Academy - New York

Syracuse University - New York

University of Rochester - New York

Teachers College, Columbia University - New York

Upstate Medical University - New York

The Cooper Union for the Advancement of Science & Art - New York

Utica College of Syracuse University - New York

The Jewish Theological Seminary of America - New York

Vassar College - New York

The Juilliard School - New York

Vaughn College of Aeronautics & Technology - New York

The Rockefeller University - New York

Wagner College - New York

Webb Institute - New York

Wells College - New York

Yeshiva University - New York

York College - New York

Appalachian State University - North Carolina

Barton College - North Carolina

Belmont Abbey College - North Carolina

Fayetteville State University - North Carolina

Bennett College - North Carolina

Gardner-Webb University - North Carolina

Brevard College - North Carolina

Greensboro College - North Carolina

Campbell University - North Carolina

Guilford College - North Carolina

Catawba College - North Carolina

High Point University - North Carolina

Chowan College - North Carolina

Johnson C. Smith University - North Carolina

Davidson College - North Carolina

Lees-McRae College - North Carolina

Duke University - North Carolina

Lenoir-Rhyne College - North Carolina

East Carolina University - North Carolina

Livingstone College - North Carolina

Elizabeth City State University - North Carolina

Louisburg College - North Carolina

Elon University - North Carolina

Mars Hill College - North Carolina

Meredith College - North Carolina

Methodist College - North Carolina

Montreat College - North Carolina

Mount Olive College - North Carolina

North Carolina A&T State University - North Carolina

North Carolina Central University - North Carolina

North Carolina School of the Arts - North Carolina

North Carolina State University - North Carolina

University of North Carolina, Chapel Hill - North Carolina

North Carolina Wesleyan College - North Carolina

University of North Carolina, Charlotte - North Carolina

Peace College - North Carolina

University of North Carolina, Greensboro - North Carolina

Pfeiffer University - North Carolina

Piedmont Baptist College - North Carolina

University of North Carolina, Pembroke - North Carolina

University of North Carolina, Wilmington - North Carolina

Queens University of Charlotte - North Carolina

Wake Forest University - North Carolina

Roanoke Bible College - North Carolina

Warren Wilson College - North Carolina

Salem College - North Carolina

Western Carolina University - North Carolina

Shaw University - North Carolina

Wingate University - North Carolina

St. Andrews Presbyterian College - North Carolina

Winston-Salem State University - North Carolina

St. Augustine's College - North Carolina

Dickinson State University - North Dakota

Jamestown College - North Dakota

University of North Carolina, Asheville - North Carolina

Mayville State University - North Dakota

Minot State University - North Dakota

North Dakota State University - North Dakota

Trinity Bible College - North Dakota

University of Mary - North Dakota

University of North Dakota - North Dakota

Cincinnati Christian University - Ohio

Valley City State University - North Dakota

Cleveland Institute of Art - Ohio

Air Force Institute of Technology - Ohio

Cleveland Institute of Music - Ohio

Antioch College - Ohio

Cleveland State University - Ohio

Art Academy of Cincinnati - Ohio

College of Mount St. Joseph - Ohio

Ashland University - Ohio

Columbus College of Art & Design - Ohio

Baldwin-Wallace College - Ohio

David N. Myers University - Ohio

Bluffton University - Ohio

Defiance College - Ohio

Bowling Green State University - Ohio

Denison University - Ohio

Capital University - Ohio

Franciscan University of Steubenville - Ohio

Case Western Reserve University - Ohio

Franklin University - Ohio

Cedarville University - Ohio

Heidelberg College - Ohio

Central State University - Ohio

Hiram College - Ohio

John Carroll University - Ohio

Kent State University - Ohio

Kenyon College - Ohio

Lake Erie College - Ohio

Ohio Northern University - Ohio

Laura & Alvin Siegal College of Judaic Studies - Ohio

Ohio State University, Columbus - Ohio

Lourdes College - Ohio

Ohio State University, Lima - Ohio

Malone College - Ohio

Ohio State University, Mansfield - Ohio

Marietta College - Ohio

Ohio State University, Marion - Ohio

Miami University of Ohio - Ohio

Ohio University - Ohio

Mount Union College - Ohio

Ohio Wesleyan University - Ohio

Mount Vernon Nazarene University - Ohio

Otterbein College - Ohio

Muskingum College - Ohio

Shawnee State University - Ohio

Northeastern Ohio Universities College of Medicine - Ohio

The College of Wooster - Ohio

Notre Dame College - Ohio

The University of Findlay - Ohio

Oberlin College - Ohio

Tiffin University - Ohio

Union Institute & University - Ohio

Ohio Christian University - Ohio

University of Akron - Ohio

Ohio Dominican University - Ohio

University of Cincinnati - Ohio

University of Dayton - Ohio

Cameron University - Oklahoma

University of Northwestern Ohio - Ohio

University of Rio Grande - Ohio

East Central University - Oklahoma

Langston University - Oklahoma

University of Toledo - Ohio

Mid-America Christian University - Oklahoma

University of Toledo Health Science Campus - Ohio

Northeastern State University, Broken Arrow campus - Oklahoma

Urbana University - Ohio

Northeastern State University, Muskogee campus - Oklahoma

Ursuline College - Ohio

Northwestern Oklahoma State University - Oklahoma

Oklahoma Baptist University - Oklahoma

Walsh University - Ohio

Oklahoma Christian University of Science & Arts - Oklahoma

Wilberforce University - Ohio

Oklahoma City University - Oklahoma

Wilmington College - Ohio

Oklahoma Panhandle State University - Oklahoma

Wittenberg University - Ohio

Oklahoma State University, Center for Health Sciences - Oklahoma

Wright State University - Ohio

Oklahoma State University, Stillwater - Oklahoma

Xavier University - Ohio

Oklahoma State University, Tulsa - Oklahoma

Youngstown State University - Ohio

Oklahoma Wesleyan University - Oklahoma

Bacone College - Oklahoma

Oral Roberts University - Oklahoma

Phillips University (closed July 1998) - Oklahoma

Eastern Oregon University - Oregon

Rogers State University - Oklahoma

Eugene Bible College - Oregon

Southeastern Oklahoma State University - Oklahoma

George Fox University - Oregon

Southern Nazarene University - Oklahoma

Lewis & Clark College - Oregon

Southwestern Oklahoma State University - Oklahoma

Linfield College - Oregon

St. Gregory's University - Oklahoma

Marylhurst University - Oregon

University of Central Oklahoma - Oklahoma

Mount Angel Seminary - Oregon

Multnomah Bible College & Seminary - Oregon

University of Oklahoma - Oklahoma

National College of Naturopathic Medicine - Oregon

University of Oklahoma Health Sciences Center - Oklahoma

Northwest Christian College - Oregon

University of Science & Arts of Oklahoma - Oklahoma

Oregon Graduate Institute of Science & Technology - Oregon

University of Tulsa - Oklahoma

Oregon Health Sciences University - Oregon

Art Institute of Portland - Oregon

Oregon Institute of Technology - Oregon

Concordia University-Portland - Oregon

Oregon State University - Oregon

Corban College - Oregon

Pacific Northwest College of Art - Oregon

Pacific University - Oregon

Portland State University - Oregon

Reed College - Oregon

Baptist Bible College - Pennsylvania

Southern Oregon University - Oregon

University of Oregon - Oregon

Bloomsburg University of Pennsylvania - Pennsylvania

University of Portland - Oregon

Bryn Athyn College of the New Church - Pennsylvania

Warner Pacific College - Oregon

Bryn Mawr College - Pennsylvania

Western Oregon University - Oregon

Bucknell University - Pennsylvania

Western States Chiropractic College - Oregon

Cabrini College - Pennsylvania

Willamette University - Oregon

California University of Pennsylvania - Pennsylvania

Albright College - Pennsylvania

Carlow College - Pennsylvania

Allegheny College - Pennsylvania

Carnegie Mellon University - Pennsylvania

Alvernia College - Pennsylvania

Cedar Crest College - Pennsylvania

American College - Pennsylvania

Chatham College - Pennsylvania

Arcadia University - Pennsylvania

Chestnut Hill College - Pennsylvania

Cheyney University - Pennsylvania

Clarion University of Pennsylvania - Pennsylvania

College Misericordia - Pennsylvania

Curtis Institute of Music - Pennsylvania

Delaware Valley College - Pennsylvania

DeSales University - Pennsylvania

Gratz College - Pennsylvania

Dickinson College - Pennsylvania

Grove City College - Pennsylvania

Dickinson School of Law - Pennsylvania

Gwynedd Mercy College - Pennsylvania

Drexel University - Pennsylvania

Haverford College in Pennsylvania - Pennsylvania

Duquesne University - Pennsylvania

Holy Family University - Pennsylvania

East Stroudsburg University of Pennsylvania - Pennsylvania

Immaculata College - Pennsylvania

Eastern College - Pennsylvania

Indiana University of Pennsylvania - Pennsylvania

Edinboro University of Pennsylvania - Pennsylvania

Juniata College - Pennsylvania

Elizabethtown College - Pennsylvania

Keystone College - Pennsylvania

Kings College - Pennsylvania

Franklin & Marshall College - Pennsylvania

Kutztown University of Pennsylvania - Pennsylvania

Gannon University - Pennsylvania

La Roche College - Pennsylvania

Geneva College - Pennsylvania

Lafayette College - Pennsylvania

Gettysburg College - Pennsylvania

Lancaster Bible College - Pennsylvania

LaSalle University - Pennsylvania

Lebanon Valley College - Pennsylvania

Lehigh University - Pennsylvania

Lincoln University - Pennsylvania

Lock Haven University of Pennsylvania - Pennsylvania

Peirce College - Pennsylvania

Lycoming College - Pennsylvania

Pennsylvania College of Optometry - Pennsylvania

Mansfield University of Pennsylvania - Pennsylvania

Pennsylvania College of Technology - Pennsylvania

Marywood University - Pennsylvania

Pennsylvania State University, Abington - Pennsylvania

Mercyhurst College - Pennsylvania

Pennsylvania State University, Altoona - Pennsylvania

Messiah College - Pennsylvania

Pennsylvania State University, Beaver - Pennsylvania

Millersville University of Pennsylvania - Pennsylvania

Pennsylvania State University, Berks - Pennsylvania

Moore College of Art & Design - Pennsylvania

Pennsylvania State University, Brandywine - Pennsylvania

Moravian College - Pennsylvania

Pennsylvania State University, College of Medicine - Pennsylvania

Mount Aloysius College - Pennsylvania

Pennsylvania State University, DuBois - Pennsylvania

Muhlenberg College - Pennsylvania

Pennsylvania State University, Great Valley - Pennsylvania

Neumann College - Pennsylvania

Pennsylvania State University, Greater Allegheny - Pennsylvania

Pennsylvania State University, Harrisburg - Pennsylvania

Pennsylvania State University, Hazleton - Pennsylvania

Pennsylvania State University, Lehigh Valley - Pennsylvania

Pennsylvania State University, Mont Alto - Pennsylvania

Pennsylvania State University, New Kensington - Pennsylvania

Saint Joseph's University - Pennsylvania

Pennsylvania State University, Schuylkill - Pennsylvania

Pennsylvania State University, Shenango - Pennsylvania

Saint Vincent College - Pennsylvania

Pennsylvania State University, The Eberly Campus - Pennsylvania

Seton Hill College - Pennsylvania

Pennsylvania State University, University Park - Pennsylvania

Shippensburg University of Pennsylvania - Pennsylvania

Pennsylvania State University, Wilkes-Barre - Pennsylvania

Slippery Rock University of Pennsylvania - Pennsylvania

Pennsylvania State University, Worthington Scranton - Pennsylvania

Susquehanna University - Pennsylvania

Pennsylvania State University, York - Pennsylvania

Swarthmore College - Pennsylvania

Philadelphia Biblical University - Pennsylvania

Temple University - Pennsylvania

The Behrend College, Erie - Pennsylvania

Philadelphia University - Pennsylvania

Point Park University - Pennsylvania

Thiel College - Pennsylvania

Robert Morris College - Pennsylvania

Thomas Jefferson University - Pennsylvania

Rosemont College - Pennsylvania

United States Army War College - Pennsylvania

Saint Francis University - Pennsylvania

University of Pennsylvania - Pennsylvania

University of Pittsburgh (main campus) - Pennsylvania

University of Pittsburgh, Bradford - Pennsylvania

University of Pittsburgh, Greensburg - Pennsylvania

Widener University - Pennsylvania

University of Pittsburgh, Johnstown - Pennsylvania

Wilkes University - Pennsylvania

University of Pittsburgh, Titusville - Pennsylvania

Wilson College - Pennsylvania

University of Scranton - Pennsylvania

York College of Pennsylvania - Pennsylvania

University of the Arts - Pennsylvania

American University of Puerto Rico - Puerto Rico

University of the Sciences in Philadelphia - Pennsylvania

Antillean Adventist University - Puerto Rico

University Park (main campus) - Pennsylvania

Caribbean University - Puerto Rico

Ursinus College - Pennsylvania

Carlos Albizu University, San Juan - Puerto Rico

Valley Forge Christian College - Pennsylvania

Centro de Estudios Avanzados de Puerto Rico y el Caribe - Puerto Rico

Villanova University - Pennsylvania

Conservatorio de Musica de Puerto Rico - Puerto Rico

Washington & Jefferson College - Pennsylvania

Escuela de Artes Plasticas de Puerto Rico - Puerto Rico

Waynesburg College - Pennsylvania

Polytechnic University of Puerto Rico - Puerto Rico

West Chester University of Pennsylvania - Pennsylvania

Ponce School of Medicine - Puerto Rico

Westminster College - Pennsylvania

Pontificia Universidad Catolica de Puerto Rico - Puerto Rico

Westminster Theological Seminary - Pennsylvania

Seminario Evangelico de Puerto Rico - Puerto Rico

Sistema Universitario Ana G. Mendez - Puerto Rico

Universidad Central de Bayamon - Puerto Rico

Universidad Central del Caribe - Puerto Rico

Universidad Interamericana de Puerto Rico, School of Law - Puerto Rico

Universidad del Este - Puerto Rico

Universidad del Sagrado Corazon - Puerto Rico

Universidad Interamericana de Puerto Rico, School of Optometry - Puerto Rico

Universidad del Turabo - Puerto Rico

Universidad Metropolitana - Puerto Rico

Universidad Interamericana de Puerto Rico (Aguadilla Campus) - Puerto Rico

University of Puerto Rico, Aguadilla - Puerto Rico

Universidad Interamericana de Puerto Rico (Arecibo Campus) - Puerto Rico

University of Puerto Rico, Arecibo - Puerto Rico

University of Puerto Rico, Bayamon - Puerto Rico

Universidad Interamericana de Puerto Rico (Barranquitas Campus) - Puerto Rico

University of Puerto Rico, Carolina - Puerto Rico

Universidad Interamericana de Puerto Rico (Bayamon Campus) - Puerto Rico

University of Puerto Rico, Cayey - Puerto Rico

Universidad Interamericana de Puerto Rico (Fajardo Campus) - Puerto Rico

University of Puerto Rico, Ciencias Medicas - Puerto Rico

Universidad Interamericana de Puerto Rico (Guayama Campus) - Puerto Rico

University of Puerto Rico, Humacao - Puerto Rico

Universidad Interamericana de Puerto Rico (Metropolitan Campus) - Puerto Rico

University of Puerto Rico, Mayaguez - Puerto Rico

Universidad Interamericana de Puerto Rico (Ponce Campus) - Puerto Rico

University of Puerto Rico, Ponce - Puerto Rico

Universidad Interamericana de Puerto Rico (San German Campus) - Puerto Rico

University of Puerto Rico, Rio Piedras - Puerto Rico

University of Puerto Rico, Utuado - Puerto Rico

Brown University - Rhode Island

Bryant College - Rhode Island

Johnson & Wales University - Rhode Island

Claflin University - South Carolina

Naval War College - Rhode Island

Clemson University - South Carolina

New England Institute of Technology - Rhode Island

Coastal Carolina University - South Carolina

Providence College - Rhode Island

Coker College - South Carolina

Rhode Island College - Rhode Island

College of Charleston - South Carolina

Rhode Island School of Design - Rhode Island

Columbia College - South Carolina

Columbia International University - South Carolina

Roger Williams University - Rhode Island

Converse College - South Carolina

Salve Regina University - Rhode Island

Erskine College - South Carolina

University of Rhode Island - Rhode Island

Francis Marion University - South Carolina

Allen University - South Carolina

Furman University - South Carolina

Anderson College - South Carolina

Johnson & Wales University-Charleston - South Carolina

Lander University - South Carolina

Benedict College - South Carolina

Limestone College - South Carolina

Bob Jones University - South Carolina

Medical University of South Carolina - South Carolina

Charleston Southern University - South Carolina

Morris College - South Carolina

Newberry College - South Carolina

North Greenville University - South Carolina

Voorhees College - South Carolina

Presbyterian College - South Carolina

Winthrop University - South Carolina

Sherman College of Straight Chiropractic - South Carolina

Wofford College - South Carolina

South Carolina State University - South Carolina

Augustana College - South Dakota

Southern Wesleyan University - South Carolina

Black Hills State University - South Dakota

Dakota State University - South Dakota

The Citadel - South Carolina

Dakota Wesleyan University - South Dakota

University of South Carolina, Aiken - South Carolina

Mount Marty College - South Dakota

University of South Carolina, Beaufort - South Carolina

National American University - South Dakota

University of South Carolina, Columbia - South Carolina

Northern State University - South Dakota

University of South Carolina, Lancaster - South Carolina

Oglala Lakota College - South Dakota

University of South Carolina, Sumter - South Carolina

Presentation College - South Dakota

University of South Carolina, Union - South Carolina

Sinte Gleska University - South Dakota

South Dakota School of Mines & Technology - South Dakota

University of South Carolina, Upstate - South Carolina

South Dakota State University - South Dakota

University of Sioux Falls - South Dakota

Freed-Hardeman University - Tennessee

University of South Dakota - South Dakota

Aquinas College - Tennessee

Johnson Bible College - Tennessee

Austin Peay State University - Tennessee

King College - Tennessee

Baptist Memorial College of Health Sciences - Tennessee

Knoxville College - Tennessee

Belmont University - Tennessee

Lambuth University - Tennessee

Bethel College - Tennessee

Lane College - Tennessee

Bryan College - Tennessee

Lee University - Tennessee

Carson-Newman College - Tennessee

LeMoyne-Owen College - Tennessee

Christian Brothers University - Tennessee

Lincoln Memorial University - Tennessee

Church of God Theological Seminary - Tennessee

Lipscomb University - Tennessee

Crichton College - Tennessee

Martin Methodist College - Tennessee

Cumberland University - Tennessee

Maryville College - Tennessee

East Tennessee State University - Tennessee

Meharry Medical College - Tennessee

Fisk University - Tennessee

Memphis College of Art - Tennessee

Middle Tennessee State University - Tennessee

Milligan College - Tennessee

Rhodes College - Tennessee

South College - Tennessee

Southern Adventist University - Tennessee

Southern College - Tennessee

University of Tennessee, Knoxville - Tennessee

Southern College of Optometry - Tennessee

Tennessee State University - Tennessee

University of Tennessee, Martin - Tennessee

Tennessee Technological University - Tennessee

University of Tennessee, Memphis - Tennessee

Tennessee Temple University - Tennessee

University of the South - Tennessee

Tennessee Wesleyan College - Tennessee

Vanderbilt University - Tennessee

Trevecca Nazarene University - Tennessee

Abilene Christian University - Texas

Tusculum College - Tennessee

Ambassador University (closed spring 1997) - Texas

Union University - Tennessee

University of Memphis - Tennessee

Amberton University - Texas

University of Tennessee, Chattanooga - Tennessee

Angelo State University - Texas

Arlington Baptist College - Texas

Art Institute of Dallas - Texas

Art Institute of Houston - Texas

Austin College - Texas

Austin Graduate School of Theology - Texas

Austin Presbyterian Theological Seminary - Texas

Baptist Missionary Association Theological Seminary - Texas

Baylor College of Dentistry - Texas

Baylor College of Medicine - Texas

Baylor University - Texas

College of Saint Thomas More - Texas

Concordia University-Texas - Texas

Criswell College - Texas

Houston Baptist University - Texas

Dallas Baptist University - Texas

Dallas Christian College - Texas

Howard Payne University - Texas

Dallas Theological Seminary - Texas

Huston-Tillotson University - Texas

DeVry University-Dallas - Texas

Jarvis Christian College - Texas

East Texas Baptist University - Texas

Lamar University - Texas

Episcopal Theological Seminary of the Southwest - Texas

LeTourneau University - Texas

Hardin-Simmons University - Texas

Lubbock Christian University - Texas

Health Sciences Center - Texas

McMurry University - Texas

Midwestern State University - Texas

Northwood University - Texas

Oblate School of Theology - Texas

Our Lady of the Lake University - Texas

Parker College of Chiropractic - Texas

Paul Quinn College - Texas

Prairie View A&M University - Texas

Rice University - Texas

Sam Houston State University - Texas

Schreiner University - Texas

South Texas College of Law - Texas

Southern Methodist University - Texas

Southwestern Adventist University - Texas

Southwestern Assemblies of God University - Texas

Texas A&M International University - Texas

Southwestern Baptist Theological Seminary - Texas

Texas A&M University, College Station - Texas

Southwestern Christian College - Texas

Texas A&M University, Commerce - Texas

Southwestern University - Texas

Texas A&M University, Corpus Christi - Texas

St. Edward's University - Texas

Texas A&M University, Galveston - Texas

St. Mary's University of San Antonio - Texas

Texas A&M University, Health Science Center - Texas

Stephen F. Austin State University - Texas

Texas A&M University, Kingsville - Texas

Sul Ross State University - Texas

Texas A&M University, Texarkana - Texas

Tarleton State University - Texas

Texas Chiropractic College - Texas

Texas Christian University - Texas

Texas College - Texas

Texas Lutheran University - Texas

Texas Southern University - Texas

Texas State University - Texas

Texas State University, San Marcos - Texas

Texas Tech University - Texas

Texas Wesleyan University - Texas

Texas Woman's University - Texas

Trinity University - Texas

University of Dallas - Texas

University of Houston (main campus) - Texas

University of Houston, Clear Lake - Texas

University of Houston, Downtown - Texas

University of Texas, Brownsville - Texas

University of Houston, Victoria - Texas

University of Mary Hardin-Baylor - Texas

University of Texas, Dallas - Texas

University of North Texas - Texas

University of Texas, El Paso - Texas

University of North Texas, Health Science Center at Ft. Worth - Texas

University of Texas, Health Center at Tyler - Texas

University of Saint Thomas - Texas

University of Texas, Health Science Center at Houston - Texas

University of Texas, Arlington - Texas

University of Texas, Health Science Center at San Antonio - Texas

University of Texas, Austin - Texas

University of Texas, M.D. Anderson Cancer Center - Texas

University of Texas, Medical Branch at Galveston - Texas

University of Texas, Pan American - Texas

University of Texas, Permian Basin - Texas

University of Texas, San Antonio - Texas

University of Texas, Southwestern Medical Center at Dallas - Texas

University of Texas, Tyler - Texas

University of the Incarnate Word - Texas

Wayland Baptist University - Texas

West Texas A&M University - Texas

Wiley College - Texas

Brigham Young University - Utah

College of Eastern Utah - Utah

Dixie State College - Utah

Southern Utah University - Utah

University of Utah - Utah

Utah State University - Utah

Utah Valley State College - Utah

Weber State University - Utah

Western Governors University - Utah

Westminster College - Utah

Bennington College - Vermont

Burlington College - Vermont

Castleton State University - Vermont

Vermont Technical College - Vermont

Averett College - Virginia

Bluefield College - Virginia

Bridgewater College - Virginia

Christendom College - Virginia

Christopher Newport University - Virginia

College of William and Mary - Virginia

DeVry University-Crystal City - Virginia

Eastern Mennonite University - Virginia

Eastern Virginia Medical School - Virginia

ECPI College of Technology - Virginia

Emory & Henry College - Virginia

Ferrum College - Virginia

George Mason University - Virginia

George Washington University-Virginia Campus - Virginia

Hampden-Sydney College - Virginia

Hampton University - Virginia

Hollins University - Virginia

Institute for the Psychological Sciences - Virginia

Institute of Textile Technology - Virginia

James Madison University - Virginia

Jefferson College of Health Sciences - Virginia

Liberty University - Virginia

Longwood University - Virginia

Lynchburg College - Virginia

Marine Corps University - Virginia

Mary Baldwin College - Virginia

Marymount University - Virginia

Norfolk State University - Virginia

Old Dominion University - Virginia

Radford University - Virginia

Randolph College - Virginia

Randolph-Macon College - Virginia

Regent University - Virginia

Roanoke College - Virginia

Saint Paul's College - Virginia

Shenandoah University - Virginia

Sweet Briar College - Virginia

United States Marine Corps University - Virginia

University of Mary Washington - Virginia

University of Richmond - Virginia

University of Virginia - Virginia

University of Virginia's College at Wise - Virginia

Virginia Commonwealth University - Virginia

Champlain College - Vermont

Virginia Intermont College - Virginia

College of St. Joseph - Vermont

Goddard College - Vermont

Green Mountain College - Vermont

Johnson State College - Vermont

Lyndon State College - Vermont

Marlboro College - Vermont

Middlebury College - Vermont

Norwich University - Vermont

Saint Michael's College - Vermont

School for International Training - Vermont

Virginia Military Institute - Virginia

Southern Vermont College - Vermont

Virginia Polytechnic Institute and State University - Virginia

Sterling College - Vermont

Virginia State University - Virginia

University of Vermont - Vermont

Virginia Union University - Virginia

Vermont Law School - Vermont

Virginia Wesleyan College - Virginia

Washington & Lee University - Virginia

Washington Bible College/Capital Bible Seminary - Virginia

Antioch University-Seattle - Washington

Art Institute of Seattle - Washington

Bastyr University - Washington

Central Washington University - Washington

City University - Washington

Heritage University - Washington

Eastern Washington University - Washington

Northwest University - Washington

Evergreen State College - Washington

Pacific Lutheran University - Washington

Gonzaga University - Washington

Seattle Pacific University - Washington

Seattle University - Washington

St. Martin's College - Washington

Trinity Lutheran College - Washington

University of Puget Sound - Washington

University of Washington (Bothell campus) - Washington

University of Washington (Seattle/Main campus) - Washington

University of Washington (Tacoma campus) - Washington

Walla Walla University - Washington

Western Washington University - Washington

Washington State University (Spokane campus) - Washington

Whitman College - Washington

Washington State University (Tri-Cities campus) - Washington

Whitworth College - Washington

Washington State University (Vancouver campus) - Washington

American University - Washington, DC

Corcoran College of Art & Design - Washington, DC

Gallaudet University - Washington, DC

George Washington University (Main campus/Foggy Bottom) - Washington, DC

George Washington University (Mount Vernon campus) - Washington, DC

George Washington University (Virginia Campus) - Washington, DC

Georgetown University - Washington, DC

Howard University - Washington, DC

Strayer University - Washington, DC

Institute of World Politics - Washington, DC

Joint Military Intelligence College - Washington, DC

The Catholic University of America - Washington, DC

National Defense University - Washington, DC

Trinity University - Washington, DC

Southeastern University - Washington, DC

University of the District of Columbia - Washington, DC

Washington Theological Union - Washington, DC

Wesley Theological Seminary - Washington, DC

Alderson-Broaddus College - West Virginia

Bethany College - West Virginia

Bluefield State College - West Virginia

Concord University - West Virginia

Davis & Elkins College - West Virginia

Fairmont State College - West Virginia

Ohio Valley College - West Virginia

Glenville State College - West Virginia

Marshall University - West Virginia

Salem International University - West Virginia

Mountain State University - West Virginia

Shepherd University - West Virginia

University of Charleston - West Virginia

West Liberty State College - West Virginia

West Virginia State University - West Virginia

West Virginia University - West Virginia

West Virginia University at Parkersburg - West Virginia

West Virginia University Institute of Technology - West Virginia

West Virginia Wesleyan College - West Virginia

Wheeling Jesuit University - West Virginia

Alverno College - Wisconsin

Beloit College - Wisconsin

Cardinal Stritch College - Wisconsin

Carthage College - Wisconsin

Carroll College - Wisconsin

Concordia University-Wisconsin - Wisconsin

Edgewood College - Wisconsin

Herzing College - Wisconsin

Lakeland College - Wisconsin

Lawrence University - Wisconsin

Maranatha Baptist Bible College - Wisconsin

Marian College of Fond du Lac - Wisconsin

Marquette University - Wisconsin

St. Norbert College - Wisconsin

Medical College of Wisconsin - Wisconsin

University of Wisconsin, Eau Claire - Wisconsin

Milwaukee School of Engineering - Wisconsin

University of Wisconsin, Green Bay - Wisconsin

Mount Mary College - Wisconsin

University of Wisconsin, LaCrosse - Wisconsin

Northland College - Wisconsin

University of Wisconsin, Madison - Wisconsin

Ripon College - Wisconsin

University of Wisconsin, Milwaukee - Wisconsin

Silver Lake College - Wisconsin

University of Wisconsin, Oshkosh - Wisconsin

University of Wisconsin, Parkside - Wisconsin

University of Wisconsin, Platteville - Wisconsin

University of Wisconsin, River Falls - Wisconsin

University of Wisconsin, Stevens Point - Wisconsin

University of Wisconsin, Stout - Wisconsin

University of Wisconsin, Superior - Wisconsin

University of Wisconsin, Whitewater - Wisconsin

Wisconsin Lutheran College - Wisconsin

Viterbo University - Wisconsin

Wisconsin School of Professional Psychology - Wisconsin

University of Wyoming - Wyoming

Other: -

Rocky Vista University College of Osteopathic Medicine - Colorado

Lake Erie College of Osteopathic Medicine (LECOM) - Pennsylvania

Pacific Northwest University of Health Sciences College of Osteopathic Medicine (PNWU-COM) - Wash...

Washington State University (Pullman Campus) - Washington

Geisinger Commonwealth School of Medicine - Pennsylvania

Specialty Loookup Table

9.4 U.S. Board Certifications and Specialty

Aerospace medicine

Allergy and immunology

Clinical and laboratory immunology

Anesthesiology

Adult Cardiothoracic Anesthesiology

Pediatric anesthesiology

Colon and rectal surgery

Dermatology

Dermatopathology

Procedural dermatology

Emergency medicine

Pediatric emergency medicine

Family medicine

Internal medicine

Cardiovascular disease

Clinical cardiac electrophysiology

Critical care medicine

Endocrinology, diabetes, and metabolism

Gastroenterology

Geriatric medicine

Hematology and oncology

Infectious disease

Interventional cardiology

Nephrology

Oncology

Pulmonary disease

Pulmonary disease and critical care medicine

Rheumatology

Sports medicine

Transplant hepatology

Medical genetics

Molecular genetic pathology

Neurological surgery

Endovascular surgical neuroradiology

Neurology

Child neurology

Orthopaedic sports medicine

Orthopaedic surgery of the spine

Orthopaedic trauma

Pediatric orthopaedics

Otolaryngology

Neurotology

Pediatric otolaryngology

Palliative and hospice care

Pathology-anatomic and clinical

Blood banking/transfusion medicine

Chemical pathology

Cytopathology

Forensic pathology

Hematology

Medical microbiology

Neuropathology

Pediatric pathology

Selective pathology

Pediatrics

Adolescent medicine

Neonatal-perinatal medicine

Pediatric cardiology

Pediatric critical care medicine

Pediatric emergency medicine

Pediatric endocrinology

Pediatric gastroenterology

Pediatric hematology/oncology

Pediatric infectious diseases

Pediatric nephrology

Pediatric pulmonology

Pediatric rheumatology

Pediatric sports medicine

Developmental-behavioral pediatrics

Physical medicine and rehabilitation

Pediatric rehabilitation

Spinal cord injury medicine

Plastic surgery

Craniofacial surgery

Clinical neurophysiology

Neuromuscular medicine

Preventive medicine (General/PH)

Neurodevelopmental disabilities

Preventive medicine (CDC PMR/F ONLY)

Vascular neurology

Nuclear medicine

Obstetrics and gynecology

Occupational medicine

Medical toxicology

Undersea and hyperbaric medicine

Ophthalmology

Orthopaedic surgery

Adult reconstructive orthopaedics

Foot and ankle orthopaedics

Psychiatry

Addiction psychiatry

Musculoskeletal oncology

Child and adolescent psychiatry

Forensic psychiatry

Geriatric psychiatry

Pain medicine

Psychosomatic medicine

Radiation oncology

Radiology, diagnostic

Abdominal radiology

Cardiothoracic radiology

Musculoskeletal radiology

Pediatric radiology

Neuroradiology

Nuclear radiology

Vascular and interventional radiology

Sleep medicine

Surgery

Hand surgery

Pediatric surgery

Surgical critical care

Vascular surgery

Vascular surgery ? Integrated

Thoracic surgery

Congenital Cardiac Surgery

Urology

Pediatric urology

Transitional year

Internal Medicine/Pediatrics

Languages Lookup Table

9.8 Language Skills

English

Afrikaans

Albanian

Amharic

Arabic (Egyptian)

Aramaic

Armenian

Assamese

Aymara

Azerbaijani

Basque

Belarusian

Bengali

Bislama

Bosnian

Bulgarian

Burmese

Catalan

Cebuano

Cherokee

Mandarin

Croatian

Czech

Danish

Dutch

Egyptian

Estonian

Finnish

French

Georgian

German

Greek

Guarani

Gujarati

Creole (Haitian)

Hausa

Hawaiian

Hebrew

Hindi

Hungarian

Icelandic

Irish

Italian

Japanese

Javanese

Kannada

Kazakh

Khmer

Korean

Lao

Latvian

Lithuanian

Macedonian

Malagasy

Malayalam

Marathi

Mongolian

Nahuatl

Navajo

Nepali

Norwegian

Oriya

Oromo

Farsi

Polish

Portuguese

Punjabi

Pashto

Romanian

Romany

Russian

Sanskrit

Serbian

Slovak

Slovenian

Somali

Spanish

Swahili

Swedish

Tagalog

Tajik

Tamil Telugu

Thai

Tibetan

Tok Pisin

Turkish

Turkmen

Ukrainian

Urdu

Uzbek

Vietnamese

Welsh

Xhosa

Yiddish

Yoruba

Zapotec

Zulu

Arabic (Levantine)

Arabic (Modern Standard)

Arabic (Moroccan)

Indonesian (Not Specified)

Bahasa Melayu

Balochi

Berber

Cantonese

Dari

Ilokano

Inuit

Kurdi

Kyrgyz

Lakota

Ojibwa

Quechua

Quiche

Uyghur

Yucatec Maya

Arabic (Not Specified)

Chinese (Not Specified)

Creole (Not Specified)

Malay

Other Spoken Language:

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Clinebell, Carter (CDC/DDPHSS/CSELS/DSEPD) (CTR)
File Modified	0000-00-00
File Created	2024-07-19

FMS Application Module Draft (track change)

Att 3_FMS Applic_07282023_tracked.docx

[PHIC] Fellowship Management System