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ASPIRE- Program Sign Up Form
ASPIRE (Advancing Scholarly Productivity In Research & Education)
Personalized assistance, from writing to editing, to publication. Receive feedback and encouragement in preparing manuscripts for submission.
1.
Your Academic role?
Faculty
Resident
Student (Medical / Graduate )
2.
Name
3.
Department
4.
Have you published before?
YES
NO
5.
What type of publication are you interested in pursuing ?
Case Report
Research Article
Review Article
Innovation Report
Patient Quality safety publication?
Other (please specify)
6.
Have you done literature search on the topic of your interest?
YES
NO
7.
Have you used EndNote?
Yes
No
Other (please specify)
8.
Do you have specific Journal in Mind?
Yes
No
If the answer is "YES" list the journal's name and
website.
9.
Do you have a collaborating mentor?
Yes
NO
If the answer is "YES" list the mentor's names &
Department
10.
Who are your co-authors (IF applicable)
Students ( List name, Year & Institution)
Residents (List name, Department & Institution)
Faculty (List name, Department & Institution)
11.
What is your goal to have this published?
Four Months
Six Months
One Year
Other (please specify)
12.
What time commitment are you prepared to give the program?
1 Hour/week
1 Hour/Month
Other (please specify)
13.
List your Email ( the account which you check regularly?)