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Providence/Boston CFAR
Core Services Request Form
DEVELOPMENTAL CORE (Core B)
Investigator Information:
First Name
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Last Name
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Gender:
Male
Female
Email Address
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Phone Number
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Academic Affiliation
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Boston University (Charles River Campus)
Boston University Medical Campus (BUMC)
Boston Medical Center (BMC)
Brown University
Tufts University
Other
Other
Investigator Level (Select one)
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Category 1: NIH Independent Investigator-Individuals who have ever been the PI on an R01 equivalent grant in HIV/AIDS (R01 equivalents include R01, R23, R29, R37 and after 2008 DP2)
Category 2: NIH Independent Investigator-Individuals who are or have ever been the PI on an R01 equivalent grant, but never in HIV/AIDS
Category 3: NIH New Investigator-Individuals who have received funding as a PI directly from NIH, but not yet at the R01 equivalent level (i.e. K, R34)
Category 4: CFAR Users who have not yet received direct funding from NIH as a PI or Co-PI funding on any NIH grant mechanism (including post doc or research fellow)
Other: Including lab staff, community members and undergraduate or graduate students
Special Emphasis Categories (Select all that apply)
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Category 5: Current recipient of Developmental Core awards, salary support, mentoring, and/or other services
Category 6: Current recipient of NIH/CFAR Administrative Supplement funds
Category 7: Member of an Underrepresented Group in Research (African American, Hispanic, American Indian,
Category 8: Woman
None
Type of service being requested:
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Funding opportunity (developmental, International)
Schedule a grant writing workshop
Request a Trainee Travel Award
Find a CFAR mentor/collaborator
Attend a Mentor Training Program
Request a K-award mentoring team
Other
Other
Please provide a brief description of the service requested.
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