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Application for Philaldelphia PERFORM-KUH Predoctoral and Postdoctoral Fellowships

THE CURRENT ROUND IS FOR 2 POST-DOC SLOTS ONLY AND IS DUE NOVEMBER 3!

Philadelphia PERFORM-KUH is accepting applications for its interdisciplinary TL1 training program for predoctoral and postdoctoral fellows in basic, translational, or clinical research in the fields of kidney, benign urologic, and benign hematologic diseases. Please refer to the RFA for the current number and type of available slots.

Prior to completing this application form, please closely review the application guidelines and eligibility criteria with your mentor(s). The full RFA is available for download on the "How to Apply" page of the Philadelphia PERFORM-KUH website. Questions regarding the application process should be sent to philly_perform_kuh@pennmedicine.upenn.edu.

Please note, all fields are required. Enter "NA" for questions that are not applicable or that you can not answer.

First Name:

* must provide value

Last Name:

* must provide value

Institution:

* must provide value

KUH Training Program Affiliation

* must provide value

Department/Division:

* must provide value

Street Address:

* must provide value

City:

* must provide value

State:

* must provide value

Zip Code:

* must provide value

Email Address:

* must provide value

Please verify your email address is correct by re-entering it below. Upon successful verification, this notice will disappear.

Verify Email Address:

* must provide value

Phone Number:

* must provide value

eRA Commons Username (enter "NA" if you do not have a username):

Please note: Selected trainees are required to have an eRA Commons account prior to being appointed. Contact your institution's signing official or account administrator to obtain a new Commons account or affiliate your existing account with your current institution.

* must provide value

Department/Division Administrator Name (e.g., research administrator, financial assistant, or other staff member assisting with pre- and post-award management):

* must provide value

Administrator's Email Address:

* must provide value

Primary Mentor Name:

* must provide value

Primary Mentor Division/Department:

* must provide value

Type of appointment applying for:

* must provide value

Name of your current predoctoral program:

* must provide value

Predoctoral students must have completed their degree-required coursework to be eligible to apply for a PERFORM-KUH Predoctoral Fellowship. Please select "yes" to confirm that you have completed your degree-required coursework. By selecting "No," you will be prompted to end this applicaton survey.

* must provide value

Yes

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Predoctoral students must have passed their qualifying exam to be eligible to apply for a PERFORM-KUH Predoctoral Fellowship. Please select "yes" to confirm that you have passed your doctoral qualifying exam. By selecting "No," you will be prompted to end this application survey.

* must provide value

Yes

reset

Postdoctoral applicants may not have more than 5 years of postdoctoral research experience to be eligible to apply for a PERFORM-KUH Postdoctoral Fellowship. Please select "No" to confirm that you have not completed at least 5 years of postdoctoral research. By selecting "Yes," you will be prompted to end this applicaton survey.

* must provide value

Yes

reset

Have you received prior NRSA support?

Per current NIH guidelines, NRSA support is limited to 5 years for predoctoral trainees (6 years for dual-degree training), and 3 years for postdoctoral fellows.

Yes

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Please provide period(s) of prior NRSA support:

The demographic questions below are required by the NIH, and will be used for reporting purposes. Please select the answer that best applies. Declining to provide information on gender, race and ethnicity, or disability does not affect consideration of an application.

Please read the NIH Diversity Notice for definitions and more information.

Please select your citizenship status:

NRSA applicants must be a United States Citizen or Permanent Resident. If you are "neither" status, then you are not eligible to apply for a PERFORM-KUH fellowship and will be prompted to end this application survey.

* must provide value

United States Citizen/Non-Citizen National

Permanent Resident

Neither

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Country of Citizenship:

* must provide value

Gender:

* must provide value

Female

Male

Other

Do not wish to provide

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Race and Ethnicity (select all that apply):

* must provide value

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Do not wish to provide

Do you have a disability(ies):

A PERFORM-KUH team member will follow up with selected scholars to discuss any required accommodations.

* must provide value

Yes

Do not wish to provide

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Research Project Title:

* must provide value

Expand

Proposal Items:

Please combine all required items below and upload a single PDF file. Longer, detailed descriptions of each component must be followed and can be found in the RFA.
Please use the proper file naming convention: Post_Nov25_YourLastName_CHOP/Drexel/Jeff/Penn/Temple.pdf.
Email the PERFORM Program Manager with any questions or issues.

Trainee/Fellowship NIH Biosketch
Research Project Plan
Personal statement
Mentor Statement of Support & Training Plan
Mentor NIH Biosketch
Reference Letter
- For pre- and post-docs: Individual from non-mentoring Lab recommendation
- For clinical fellows: Department Chairman, Division Chief, or Training Program Director statement of support

Upload single PDF containing all appropriate elements above:

* must provide value

Upload file

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.