Select cohort:
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(Cohort 11) 2024-2025
Current date:
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Today M-D-Y (M-D-Y)
Choose the primary PRIDE program to which you will apply (programs listed are those previously available in PRIDE 3): There is a rolling deadline for pre-applications. However, pre-applications received before April 30, 2024 will be prioritized.
RISE is full and no longer accepting pre-applications * must provide value
Arizona Approaches to Equity: Pandemics, Lungs, and Sleep (AAPLS)
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)
Health AI and Data Science in Cardiovascular and Pulmonary Disease: Application and Bioethics (HARP-BIO)
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.)
Dr. Mr. Mrs. Ms.
First name:
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Last name, family name, or surname:
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Other names under which you have published:
(lastname, firstname middlename; example: Kennedy, John Fitzgerald)
Home street address (1):
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City:
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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:
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Cell phone:
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Do you have a LinkedIn Account?
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Yes
No
If so, what is your account name?
What is your sex?
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Male
Female
Citizenship:
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U.S. Citizen Permanent Resident Other (specify)
Specify other:
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Do you consider yourself Hispanic / Latin(o/a)?
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Yes
No
Declined
Don't know
Which of the following represent your Hispanic origin or ancestry?
(Check all that apply.)
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What race do you consider yourself to be?
(Check all that apply.)
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Which Native Hawaiian and / or Pacific Islander group?
(Check all that apply.)
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Specify other:
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Which Asian group?
(Check all that apply.)
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Specify other:
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Do you have a disability?
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I have disability
I don't have disability
Which disability do you have?
(Check all that apply.)
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Specify other:
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If special accommodations are required, please specify:
Do you come from a disadvantaged background?
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Yes
No
Check all that apply for disadvantaged status:
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The primary goal of the PRIDE program is to train junior faculty who have an interest in broadening the demographic profile of biomedical research in the heart, lung, blood and sleep domains. Please provide a statement indicating how your background may contribute to this goal and have a potential positive impact in equity and social justice issues in these domains of human health and health care. (5,000 character limit)
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Institution of PRIMARY faculty appointment:
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PRIMARY department:
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What is your PRIMARY faculty rank?
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Instructor Assistant Professor Associate Professor Full Professor Transitioning Post-Doctoral Trainee Research Scientist Adjunct Professor None of the above
Specify other:
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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?
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Yes
No
Date of PRIMARY faculty appointment:
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Today M-D-Y (M-D-Y)
Institutional street address (1):
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Institutional street address (2):
City:
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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:
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Institutional email address:
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Do you have an Administrative Assistant?
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Yes
No
Administrative Asst. name:
Administrative Asst. phone:
Administrative Asst. email address:
Have you ever been supported on a research grant?
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Yes
No
If Yes, specify funding entity and type of grant:
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Yes
No
Grant mechanism:
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Grant # for R01:
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Specify other R-type grant mechanism (e.g., R21, R25, etc.):
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Grant # for other R-type grant mechanism:
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Specify other program grant mechanism (e.g., P30, U01, etc.):
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Grant # for other program grant mechanism:
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Specify other grant mechanism:
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Grant # for other grant mechanism:
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Are you CURRENTLY funded on a K Award?
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Yes
No
Grant type:
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Grant #
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Start date (mm):
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Start date (yyyy):
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End date (mm):
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End date (yyyy):
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Are you CURRENTLY funded on any other training grant or career development award (R25, T32)?
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Yes
No
Grant type:
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Grant #
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Start date (mm):
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Start date (yyyy):
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End date (mm):
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End date (yyyy):
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Do you have an NIH grant application CURRENTLY pending?
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Yes
No
Grant Type:
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Project start date:
* must provide value
Today M-D-Y
Anticipated Notice of Award date:
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Today M-D-Y
Do you have an eRA Commons username?
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Yes
No
eRA Commons username:
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Research field - Type of Research:
(Check all that apply.)
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Specify other:
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Research field - Topics of Interest:
(Check all that apply.)
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Specify other:
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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)
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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, sleep conditions, or cross-cutting HLBS areas such as health disparities or implementation science. (Space limit of 5,000 characters)
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Highest degree earned:
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Medical (e.g., MD, DO, etc.) Nonmedical Doctorate (e.g., PhD, ScD, etc.) Combined MD / PhD Other (specify)
Specify other:
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Preferred Credentials
e.g., Jane Smith, PhD, RN
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Year highest degree awarded (yyyy):
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Please name file as shown below:
Last name followed by First Initial [no spaces]_file name_yyyy-mm-dd
Examples ...
George Washington's CV:
Washington, George CV
Abraham Lincoln's Biosketch:
Lincoln, Abraham Biosketch
Attach your Curriculum Vita in PDF 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 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?
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Previous PRIDE or SIPID Scholar Email or discussion from Dept. Chair, Advisor, Mentor, Colleague, etc. NHLBI website or contact Direct Contact from PRIDE site National Meeting Social Media Other
Please describe your referral source in more detail:
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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:
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Title:
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Institution:
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Department:
* must provide value
Mailing Street address (1):
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Mailing street address (2)
City:
* 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:
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Phone:
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Email:
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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
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.
Submit
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