subject_line
Request for CFAR mentor/collaborator
First Name
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Last Name
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Email address
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Are you looking for an HIV mentor and/or collaborator?
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Mentor
Collaborator
Both
Are you currently a member of the Providence/Boston CFAR?
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🛈
Yes
No
Home academic institution
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Brown University
Boston University (Charles River Campus)
Boston University Medical Campus (BUMC)
Boston Medical Center
Tufts University
Moi University/Moi Teaching & Referral Hospital (Kenya)
University of the Philippines
University of Namibia
Makerere University (Uganda)
University of Zambia
Other
If you indicated "other" as your home institution, please indicate your home institution here.
What type of HIV research are you interested in pursuing?
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Basic Science
Behavioral & Social Sciences
Clinical Research
Biostatistics
Cost effectiveness
Global Health
Other
Other
Topic or area of research focus:
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What is the anticipated role of the CFAR collaborator or mentor? (i.e., guidance in study design, grant application, new area of research, need help in recruiting a specific population, etc.)
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Are you working towards a specific deadline?
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Yes
No
Please provide date of deadline
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Please include any additional information that may be helpful in identifying an appropriate mentor or collaborator.