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voucher@tuftsctsi.org Please download the document templates required for your submission.
RESEARCH STRATEGY: Only one research strategy document required per application.
SIGNATURE PAGE: Only one signature page is required per application.
BIOSKETCH INSTRUCTIONS AND SAMPLE: Please read the instructions carefully and then download the biosketch template.
BIOSKETCH TEMPLATE: Please download the biosketch template and complete it according to the guidelines above. You will be asked to upload completed biosketches for senior/key personnel only. Senior/key personnel are defined as individuals who contribute to the scientific development or execution of a project in a substantive, measurable way. This may or may not include all collaborators on the project.
All letters of commitment should be written by investigators' Department Chairs, Division Chiefs, or other individuals in positions to commit that the applicants will have sufficient protected time in order to conduct the proposed study in the CTRC.Principal investigators are required to submit at least one letter of commitment.
Document download section end
Project title
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Project descriptionPlease provide an abstract or brief description of your project (250 words or less)
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RESEARCH STRATEGY:
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SIGNATURE PAGE:
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Project information section end
First name
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Last name
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Email addressPlease provide email address associated with your primary affiliation.
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e.g. jsmith@tufts.edu
Phone numberPlease provide phone number associated with your primary affiliation.
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e.g. 617-636-5000
eRA Commons username
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Degree(s)
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Check all graduate degrees that apply
Degree(s), other
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Title or position
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Do you currently have an academic appointment?
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Yes No
Academic rank
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Distinguished Professor/Distinguished Clinical Professor Professor/Clinical Professor Associate Professor/Clinical Associate Professor Assistant Professor/Clinical Assistant Professor Lecturer Instructor Adjunct Professor Other
Academic rank, other
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Primary affiliation
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Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baim Institute for Clinical Research Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information & Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
PRIMARY AFFILIATION
Primary affiliation, other
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School or center
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Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
School or center, other
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DepartmentPlease provide the department name. If your organization does not have a department, simply input NA.
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BIOSKETCH OF PRINCIPAL INVESTIGATOR : Please upload principal investigator's completed bioscketch.
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Principal Investigator section end
Number of collaborators
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0 1 2 3 4
Collaborator information section end
COLLABORATOR 1 INFORMATION Collaborator's role on the project:
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Site PI Co-Investigator Other
Collaborator's first name
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Collaborator's last name
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Collaborator's email address
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Collaborator's eRA Commons username
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Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Degree(s), other
* must provide value
Collaborator's title or position
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baim Institute for Clinical Research Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information & Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
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Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
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BIOSKETCH OF COLLABORATOR 1 : Please upload collaborator's completed bioscketch.
Please note that bioskeches are required for senior/key personnel only.
COLLABORATOR 2 INFORMATION Collaborator's role on the project:
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Site PI Co-Investigator Other
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's email address
* must provide value
Collaborator's eRA Commons username
* must provide value
Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Degree(s), other
* must provide value
Collaborator's title or position
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baim Institute for Clinical Research Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information & Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
BIOSKETCH OF COLLABORATOR 2 : Please upload collaborator's completed bioscketch.
Please note that bioskeches are required for senior/key personnel only.
COLLABORATOR 3 INFORMATION Collaborator's role on the project:
* must provide value
Site PI Co-Investigator Other
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's email adrdress
* must provide value
Collaborator's eRA Commons username
* must provide value
Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Degree(s), other
* must provide value
Collaborator's title or position
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baim Institute for Clinical Research Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information & Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
BIOSKETCH OF COLLABORATOR 3 : Please upload collaborator's completed bioscketch.
Please note that bioskeches are required for senior/key personnel only.
COLLABORATOR 4 INFORMATION Collaborator's role on the project:
* must provide value
Site PI Co-Investigator Other
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's email address
* must provide value
Collaborator's eRA Commons username
* must provide value
Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Degree(s), other
* must provide value
Collaborator's title or position
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baim Institute for Clinical Research Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information & Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
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BIOSKETCH OF COLLABORATOR 4 : Please upload collaborator's completed biosketch.
Please note that bioskeches are required for senior/key personnel only.
Please indicate how many letters of commitment and/or additional documents you plan to upload
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1 2 3 4 5 6 7 8 9 10
Please note that principal investigators must submit at least one letter of commitment.
Document 1 description:
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Please upload the document 1 for review
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Please upload the document 2 for review
Please upload the document 3 for review
Please upload the document 4 for review
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Please upload the document 8 for review
Please upload the document 9 for review
Please upload the document 10 for review
APPLICANT CERTIFICATION AND AUTHORIZATION
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Principal investigator's signature
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Please type in your first name and last name.
Principal investigator's signature date
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Today M-D-Y
Please review your information prior to final submission.
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