Provide the following information in the order listed below. Do not exceed four pages. /
NAME OF APPLICANT / CURRENT POSITION TITLE
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, and conclude with current predoctoral training.)
INSTITUTION AND LOCATION / DEGREE(if applicable) / YEAR(s) / FIELD OF STUDY /
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A. Personal Statement. Describe current research, summer course learning goals, and plans to apply knowledge gained from the course, all within the 500 word limit. Applicants will be evaluated on the clarity of their stated research career goals and their justification of why they expect to benefit from a course in clinical and translational researchB. Positions and Certifications. List in chronological order all non-degree training including internships and postbaccalaureate research training, and all employment after college. Include information on certifications (actual and anticipated with dates) in addition to other information requested. State the Activity/Occupation and include beginning/end dates, field, name of institution/company, and the name of your supervisor/employer.
ACTIVITY/OCCUPATION / BEGINNINGDATE (mm/yy) / ENDING
DATE (mm/yy) / FIELD / INSTITUTION/COMPANY / SUPERVISOR/
EMPLOYER /
Add activity or occupation / Add start date / Add end date / Add field / Add institution or company / Add supervisor or employer; use the Tab key to add new row