APPLICANT / MENTOR
Name, Degree(s): / Name, Degree(s):
Academic/Research Title: / Full Academic Title:
Department: / Department:
Institution: / Institution:
Address: / Address:
Telephone: / Telephone:
Email: / Email:
Country of Birth:
Gender / APPLICANT’S EDUCATIONAL HISTORY
Institution where project will be conducted / Undergraduate School:
Degree/year awarded:
COMPLETED YEARS OF FULL-TIME POSTDOC EXPERIENCE
by May 1, 2018
1 2 3 4 5 / Graduate School:
Degree/year awarded:
Other graduate degree(s):
DATE OF FIRST Full-Time Postdoc Research / PH.D. Dissertation (Day/Month) (Year)
Day/Month: ______Year: ______/ (if applicable)
AUTHORIZED INSTITUTIONAL REPRESENTATIVE / INSTITUTIONAL OFFICER TO RECEIVE FUNDS
Name: / Name: / ______
______
______
Title: / Title:
Institution: / Institution:
Email: / Email:
CERTIFICATION: By signing this Face Sheet, we certify that the statements contained in this application are true and complete to the best of our knowledge, and agree to accept the terms of The Hilda and Preston Davis Foundation Awards Program for Eating Disorders Research as documented in the Application Guidelines and Terms of the Award. The Applicant and Mentor also confirm that they are responsible for obtaining any required human subjects (IRB), animal use (IACUC), and/or other required institutional approvals. PLEASE SIGN AND DATE BELOW.
Signature of Applicant / Date / Signature of Authorized Institutional Representative / Date
Contact: Charlene Mancusi, Grants Officer,
Table of Contents
Application Face Sheet* 1
Table of Contents* 2
Project Summary* (maximum of 350 words) 3
Applicant’s Biosketch* (maximum of 5 pages) 4
Research Proposal (maximum of 6 pages)
· Background and Significance
· Specific Aims
· Preliminary data (if available)
· Research design, experimental methods and analytical plan
· Research limitations and contingencies
· Projected Timeline of proposed research project
· References Cited (not part of page count)
Mentor’s Biosketch and List of Trainees (maximum of 6 pages)
Thesis Advisor Explanation (if applicable for Ph.D.) ......
*Templates included in this document.
PROJECT SUMMARY
Maximum length: 350 words
Applicant’s Name:Institution:
Mentor’s Name:
Title of Project:
Key Words:
Please include a 350-word summary stating the project’s broad, long-term objectives and specific aims. The same Project Summary should be used for both the Online Submission and this form.
MODIFIED FOR DAVIS FOUNDATION FELLOWSHIP PROGRAM: OMB No. 0925-0001 and 0925-0002 (Rev. 09/17 Approved Through 03/31/2020)
MODIFIED APPLICANT BIOGRAPHICAL SKETCH
DO NOT EXCEED FIVE PAGES.
NAME:
eRA COMMONS USER NAME (credential, e.g., agency login):
POSITION TITLE:
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
INSTITUTION AND LOCATION / DEGREE(if applicable) / Completion Date
MM/YYYY / FIELD OF STUDY /
NOTE: Instruction below should be deleted before final submission.
A. Personal Statements
1. Provide a brief outline of your career plans and trajectory (150 word limit). Please include how this fellowship would assist in your future research career path and describe your current job-seeking situation.
2. Briefly describe why your experience and qualifications make you particularly well-suited for your role in the project that is the subject of the application. Include a brief 2-3 sentence description of your Mentor’s contribution and your level of independence on the project. If there was a lapse in your postdoctoral research experience/full-time employment, please explain here.
B. Positions and Honors
1. List in chronological order positions held since the completion of your most recent degree, concluding with your present position.
2. List any relevant academic and professional achievements and honors, such as scholarships, traineeships, fellowships, and development awards, as applicable.
C. Contribution to Science: Publications
Important! Applicants must have at least one primary, peer-reviewed, research article from their postdoctoral work either published or in press by the application deadline to be eligible for this award. Articles in press, or submitted for review should be publicly available as a preprint (e.g. BioRxiv).
List all of your publications in chronological order (Most recent first)
1. Clearly distinguish post- and pre-doctoral work. Indicate by BOLD titles, all those publications that are from postdoctoral work. Do not BOLD those publications coming after receiving your degree but reflecting your graduate work, unless your current postdoctoral work continued in this laboratory.
2. Indicate your five most significant publications or preprints with asterisks ahead of each relevant citation. Under each of these citations, include a paragraph summarizing its impact and significance (300 word maximum per citation). This description may include the historical background framing a scientific problem; the central finding(s); the influence of the finding(s) on the progress of science or the application of those finding(s) to health or technology; and your specific role in the described work. These publications are not required to be related to the proposed project.
3. Include a URL hyperlink to a full list of your publications and be sure that these include the five highlighted publications or preprints cited above (such as BioRxiv, PubMed or My Bibliography.)
D. Additional Information: Research Support
List selected ongoing and completed research projects for the past three years (Federal or non-Federal support). Briefly indicate the overall goals of the projects and your responsibilities. Do not include number of person months or direct costs.
List any other pending research funding you have applied for.
If the applicant does not have Research Support, please write N/A.