CTSI TL1Predoctoral Education & Training Program

Application for Predoctoral Graduate Students

Initial Funding Period: August 16, 2015through August 15, 2016

Applications must be submitted by email to:

Deadline for submission: 5 p.m. on Monday, June 29, 2015

Finalist interviews: early July 2015

Award notification: by July 31, 2015

See the TL1 Training Grant webpage for eligibility details, program requirements and application instructions:

PART ONE –APPLICANT and MENTOR INFORMATION

Applicant’s Name: ______UFID: ______E-mail Address: ______

Campus Address: ______Preferred Phone: ______

Graduate Program: ______Major/Concentration:______

UF Department: ______UF College: ______

Proposed Research Project Title: ______

Demographics Information: Date of Birth: ______Gender: □ Male □ Female

What is your ethnic origin? Please mark all that apply:

□ Asian □ White □ Black or African American □ Hispanic, Latino

□ Native American or Alaskan Native □ Native Hawaiian or other Pacific Islander

□ Other (please specify) ______

Citizenship (note: only US Citizens and Permanent Residents are eligible to apply):

□ United States □ Permanent Resident (country of citizenship: ______)

Proposed Basic Science Mentor:

Name: ______UFID:______PO Box: ______

Title: ______Department/Division: ______

Telephone: ______E-mail: ______

Proposed Clinical/Translational Science Mentor:

Name: ______UFID:______PO Box: ______

Title: ______Department/Division: ______

Telephone: ______E-mail: ______

CTSI TL1 Predoctoral Education & Training

Application for Predoctoral Graduate Students

PART TWO: APPLICANT STATEMENTS and RESEARCH PLAN

Please provide the following information, start a new page for each item.

Font size must be 11 or 12 point.

1. Please describe your research interests, theimportance of this training program and your choice of mentorsfor achieving your career goals.

Please limit your statement to no more than one page.

2. Personal Statement: Briefly outline why you are a strong candidate for this program.

Please limit your statement to a half page.

3. Provide a short description of anyprevious research experiences and training.

Please limit your statement to a half page.

4. Listallpublications, abstracts, or manuscripts published or in preparation. Provide full title, full names of all authors, and full citation.

5. Please describe your Research Plan: This should include your project title, a statement of the problem, hypotheses to be tested, experimental design, and a timeline for completion.

Be sure to include:

  • An explicitly stated hypothesis and a summary of any preliminary data based on your work or the work of others in your lab.
  • Clearly stated clinical/translational AND basic science components of your research plan (see theTL1 Training Grantwebpage for definitions).

Please limit your Research Plan to 2 pages.

PART THREE: APPLICANT EDUCATION

Education – Post-High School / Degree Received / Date Received – mm/yy / Major Field of Study

GRE scores: ______

GPA: UF Graduate Work* ______Prior Graduate Work*______BA/BS*______

*Please attach copies of transcripts

PART FOUR: MENTOR INFORMATION

For each mentor, please provide the following documents:

  1. NIH Biosketch (limit 4 pages) that includes current and pending funding.
  2. Letter of support for applicant, indicating approval and familiarity with the proposed project, frequency and type of contact, understanding and support of the requirements of the program.
  3. Brief description of the proposed research training plan and relevance to clinical and/or translational research.
  4. List of current and past trainees, including dissertation topic, current status, and current position.

PART FIVE: APPLICATION SUBMISSION

Please submit your application packet, mentors’materials, andcopies of transcripts and GRE scores as a single searchable .pdf document no larger than .

All documents must be submitted electronicallyby 5:00 p.m. on Monday, June 29, 2015. Paper documents will not be accepted. Interviews of finalists will take place in early July, 2015, and awards are expected to be announced no later than July 31, 2015.

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