Select cohort:* must provide value
(Cohort 10) 2022-2023
Current date:* must provide value
Today M-D-Y (M-D-Y)
Choose the primary PRIDE program to which you will apply:
There is a rolling deadline for pre-applications. However, pre-applications received before March 31, 2022 will be prioritized.
RISE , CVD, and FTG ARE NO LONGER TAKING PRE-APPLICATIONS. * must provide value
Advanced Respiratory Research for Equity (AIRE)
Behavioral and Sleep Medicine (BSM)
Cardiovascular Disease Comorbidities, Genetics, and Epidemiology (CVD-CGE)
Cardiovascular Health-Related Research (CVD)
Future Faculty of Cardiovascular Sciences (FOCUS)
Functional and Translational Genomics of Blood Disorders (FTG)
Impact of Ancestry and Gender On Omics of Lung Diseases (AGOLD)
Obesity Health Disparities (OHD)
Research in Implementation Science for Equity (RISE)
Choose any other PRIDE program(s) in which you are interested. (Check all that apply.)
Advanced Respiratory Research for Equity (AIRE)
Behavioral and Sleep Medicine (BSM)
Cardiovascular Disease Comorbidities, Genetics, and Epidemiology (CVD-CGE)
Cardiovascular Health-Related Research (CVD)
Future Faculty of Cardiovascular Sciences (FOCUS)
Functional and Translational Genomics of Blood Disorders (FTG)
Impact of Ancestry and Gender On Omics of Lung Diseases (AGOLD)
Obesity Health Disparities (OHD)
Research in Implementation Science for Equity (RISE)
Courtesy title: Dr. Mr. Mrs. Ms.
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Other names under which you have published:
(lastname, firstname middlename; example: Kennedy, John Fitzgerald)
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Home street address (2):
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State / Territory:
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Click for List of states' and territories' abbreviations ]* must provide value
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Home phone:
Do you have a LinkedIn Account?* must provide value
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No
If so, what is your account name?
What is your sex?* must provide value
Male
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Citizenship:* must provide value
U.S. Citizen Permanent Resident Other (specify)
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Do you consider yourself Hispanic / Latin(o/a)?* must provide value
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No
Declined
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Which of the following represent your Hispanic origin or ancestry?
(Check all that apply.)* must provide value
Puerto Rican
Dominican (Republic)
Mexican / Mexican American
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Other Hispanic or Latin(o/a)
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What race do you consider yourself to be?
(Check all that apply.)
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American Indian / Alaska Native
Asian
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White
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Which Native Hawaiian and / or Pacific Islander group?
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Native Hawaiian
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Which Asian group?
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Chinese
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I have disability
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Which disability do you have?
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Physical
Auditory
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Other (specify)
Declined
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If special accommodations are required, please specify:
Do you come from a disadvantaged background? * must provide value
Yes
No
To qualify as disadvantaged you must meet two or more of the following criteria. (Check all that apply) * must provide value
Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act
Were or currently are in the foster care system, as defined by the Administration for Children and Families
Were eligible for the Federal Free and Reduced Lunch Program for two or more years
Have/had no parents or legal guardians who completed a bachelor's degree
Were or currently are eligible for Federal Pell grants
Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child
Grew up in one of the following areas: a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas
Justification of disadvantaged status:
If you wish to attach a statement below please write N/A in the text box here. * must provide value
You may upload a statement on why you qualify for disadvantaged status here:
Institution of PRIMARY faculty appointment:* must provide value
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Instructor Assistant Professor Associate Professor Full Professor Transitioning Post-Doctoral Trainee Research Scientist Adjunct Professor None of the above
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WARNING
You must have a faculty-level appointment PRIOR TO the start of the Summer Institute Program (June - August; dates vary by program) to be eligible for the PRIDE Programs. Your Department Chair will be asked to provide a letter documenting your appointment.
Will / Do you have a faculty appointment prior to the Summer Institute?* must provide value
Yes
No
Date of PRIMARY faculty appointment:* must provide value
Today M-D-Y (M-D-Y)
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Institutional street address (2):
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[Format: 2 letter abbreviation -
Click for List of states' and territories' abbreviations ]
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Alternate email address:
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Yes
No
Administrative Asst. name:
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Administrative Asst. email address:
Have you ever been supported on a research grant?* must provide value
Yes
No
If Yes, specify funding entity and type of grant:* must provide value
Have you ever been a Principal Investigator (PI) on an NIH-funded grant?
Follow this link for NIH definition of Principal Investigator .
Click browser "Back" button to return to this form.* must provide value
Yes
No
Grant mechanism:* must provide value
R01
Other R-type Grant (R21, R25, etc.)
Other Program Grant (P30, U01, etc.)
Other Grant Mechanism (specify)
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Are you CURRENTLY funded on a K Award? * must provide value
Yes
No
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Grant #* must provide value
Start date (mm):* must provide value
Start date (yyyy):* must provide value
End date (mm):* must provide value
End date (yyyy):* must provide value
Are you CURRENTLY funded on any other training grant or career development award (R25, T32)? * must provide value
Yes
No
Grant type:* must provide value
Grant #* must provide value
Start date (mm):* must provide value
Start date (yyyy):* must provide value
End date (mm):* must provide value
End date (yyyy):* must provide value
Do you have an NIH grant application CURRENTLY pending? * must provide value
Yes
No
Grant Type:* must provide value
Project start date:* must provide value
Today M-D-Y
Anticipated Notice of Award date:* must provide value
Today M-D-Y
Do you have an eRA Commons username?* must provide value
Yes
No
eRA Commons username:* must provide value
ORCID ID:
ORCID ID Requirement * must provide value
Research field - Type of Research:
(Check all that apply.) Basic Science
Behavioral
Clinical
Epidemiology
Genetics
Health Disparities
Dissemination and Implementation
Methodology
Statistics
Other (specify)
Specify other:* must provide value
Research field - Topics of Interest:
(Check all that apply.)* must provide value
Cardiovascular / Heart
Lung
Blood
Sleep
Other (specify)
Specify other:
This PRIDE Training Program is funded by NHLBI. Your research field must be related to Heart, Lung, Blood or Sleep Disorders.
Please provide a brief description of your current and future research interests, and how this program can facilitate your research study. (Space limit of 5,000 characters)* must provide value
PRIDE will offer an opportunity to compete for Small Research Projects (SRP) acting as pilot grants to generate preliminary data for developing NHLBI grant applications. Please give a brief overview of your research plans to take advantage of this opportunity. Describe how your SRP will incorporate the NHLBI research focus on heart, lung, blood, or sleep disorders. (Space limit of 5,000 characters)* must provide value
Highest degree earned:* must provide value
Medical (e.g., MD, DO, etc.) Nonmedical Doctorate (e.g., PhD, ScD, etc.) Combined MD / PhD Other (specify)
Specify other:* must provide value
Preferred Credentials
e.g., Jane Smith, PhD, RN * must provide value
Year highest degree awarded (yyyy):
* must provide value
Please name file as shown below:
Last name followed by First Initial [no spaces]_file name_yyyy-mm-dd Examples ...
George Washington's CV:
WashingtonG_CV_2019-03-01 Abraham Lincoln's Biosketch:
LincolnA_Biosketch_2019-03-01 Attach your Curriculum Vita in pdf form to your application by clicking Upload document at right:* must provide value
If you have a Biosketch (not required) , please upload your most recent version in pdf form by clicking Upload document at right:
If you don't have a Biosketch and would like to create one , please use the template for new format found in this NIH link .
Your optional Biosketch may be sent later to the PRIDE CC BIOSTAT-pridecc@email.wustl.edu
Please tell us how you learned about the PRIDE Summer Institute Program?* must provide value
Previous PRIDE or SIPID Scholar Department Chair Advisor Colleague Email Advertisement Brochure Flyer or Poster NHLBI Website Other Website Local Specialty Society Meeting National Specialty Society Meeting Word of Mouth LinkedIn / Facebook Direct Mailing Other
Please describe your referral source in more detail:
Name of previous PRIDE or SIPID Scholar
Two recommendations are required to complete your application: one from your current Department Chair and one from a colleague or mentor.
Please provide the information requested below, so we may contact each of your referees directly to request their recommendation. Also, please let them know that a representative from the PRIDE Coordinating Center will be contacting them, and that the email request for this recommendation will come from Washington University in St. Louis School of Medicine.
We strongly recommend that you follow up with your referees to ensure their timely submission of your recommendation to the PRIDE Coordinating Center. No evaluation of your application material can be made until your recommendations have been received.
Your referees will only be contacted if you are invited to complete a full application. A letter of recommendation and support must be received from your Department Chair that guarantees your full participation in the program, as follows:
1. Devote 5% protected time and effort throughout the program
2. Devote 100% effort to all program activities as outlined under "% Effort Commitments"
3. Have access to institutional resources for preparing grant applications
4. Verify date of faculty appointment Name of Department Chair: * must provide value
Title: * must provide value
Institution: * must provide value
Department: * must provide value
Mailing Street address (1): * must provide value
Mailing street address (2)
City: * must provide value
State / Territory:
Click for List of states' and territories' abbreviations * must provide value
AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ----- AS FM GU MH MP PW PR VI
Zip code: * must provide value
Phone: * must provide value
Email: * must provide value
Does your Dept. Chair have an Administrative Assistant? * must provide value
Yes No
Administrative Assistant name: * must provide value
Administrative Assistant Phone: * must provide value
Administrative Assistant email address: * must provide value
A representative from the PRIDE Coordinating Center will contact your Department Chair to request a recommendation on your behalf. Note that, although the questions in this section include 'Colleague,' the RISE PRIDE Program requires the recommendation come from a senior Faculty member, NOT a Colleague. Name of Mentor or Colleague:* must provide value
Title of Mentor or Colleague: * must provide value
Institution: * must provide value
Department: * must provide value
Mailing street address (1): * must provide value
Mailing street address (2):
City: * must provide value
State / Territory:
Click for List of states' and territories' abbreviations * must provide value
AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ----- AS FM GU MH MP PW PR VI
Zip code: * must provide value
Phone: * must provide value
Email address: * must provide value
Does your mentor / colleague have an administrative assistant? * must provide value
Yes No
Administrative assistant name: * must provide value
Administrative assistant phone: * must provide value
Administrative assistant email address: * must provide value
A representative from the PRIDE Coordinating Center will contact your mentor or colleague to request a recommendation on your behalf. Submission of this form allows the PRIDE CC to contact you for additional information regarding your application and career development.
When you are ready, click the Submit button below to send us your pre-application.
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