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* 1. PI Name

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* 2. Degrees

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* 4. University/School - Primary Appointment

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* 5. Department

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* 6. Project Title

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* 7. Location of the Project
International Studies will require NIH clearance

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* 8. Proposed Mentors

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* 11. Date of Terminal Degree (To assess Early-staged investigator status)
You may enter 01 for month or day if unknown.

Date

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* 13. Other potential funding source:

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* 15. Are the participants prospectively assigned to an intervention?

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* 16. Is the study designed to evaluate the effect of the intervention on the participants?

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* 17. Is the effect being evaluated a health-related biomedical or behavioral outcome?

If the answer is "yes" to questions 25 - 27 above, then this study would be considered a clinical trial according to the NIH definition and is not fund-able by the CFAR.

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* 23. Upload Application Packet as described in the announcement as a single PDF

T