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GMaP Profile Update - 2021 - 2022
Please complete this form if you plan to apply for any NCI or NIH Award (including CURE Diversity Awards (
https://www.cancer.gov/about-nci/organization/crchd/diversity-training/cure
) in 2021 or 2022.
Now is the time to begin utilizing GMaP's programs - consider expert grant review, or connection with NCI's Training Navigation Officer or other Program Directors.
If you have any questions, please contact your GMaP Regional Coordinating Director Carrie Norbeck at
Carrie.Norbeck@fccc.edu
.
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What is your name?
Your answer
What is your institution?
Your answer
What is your email address?
Your answer
What is your career level?
Undergraduate
Graduate/Pre-doctoral/Clinical Doctorate
Postdoctorate/Residency
Early Career (Early Established Investigator (EEI) or Early Stage Investigator (ESI))
Established Investigator
Clear selection
What is your Primary Mentor's Name?
Your answer
Are you eligible for a CURE award?
Yes
No
Unsure
Do not wish to answer
Clear selection
Are you a PACHE Trainee/ESI?
Yes
No
Unsure
Do not wish to answer
Clear selection
What is your research type?
Basic
Clinical
Population/Behavioral Health
Translational Health
Other:
Clear selection
What grant type will you submit?
Diversity Supplement
Diversity F31
Diversity K01
Diversity K08
Diversity K22
Diversity R21
R01
Other NCI Award (please describe)
Other NIH Award (please describe)
Other (please describe)
Clear selection
If you selected "Other" or are applying to multiple grants, please elaborate here.
Your answer
What date(s) will you submit? (Month/Year)
Your answer
What is the (anticipated) title(s) of your grant submission?
Your answer
Would you like to utilize the GMaP Expert Grant Review program for this submission?
Yes
No
Unsure
Do not wish to answer
Clear selection
Have you received a GMaP Award (Travel, Pilot, or Research Stimulus) in the past?
Yes
No
Unsure
Do not wish to answer
Clear selection
Have you participated in a GMaP workshop or webinar in the past?
Yes
No
Unsure
Do not wish to answer
Clear selection
Have you participated in any other GMaP sponsored event or activity in the past? If yes, please describe.
Your answer
Which of the following GMaP Funding Support programs would you most anticipate utilizing over the next 1-2 years?
Travel Awards (Up to $750 per conference for early stage investigators)
Pilot Awards (Up to $5,000 for research support/feasibility data)
Biospecimen Awards (Up to $5,000 for the purchase of samples for research support/feasibility data)
Research Stimulus Awards (Up to $1,500 for various use related to training, research, publication fees, dataset purchase)
Grant Review (Honorariums offered to reviewers to facilitate the review process)
Other:
Clear selection
Which training topic would be of most benefit to you on a future GMaP webinar?
Your answer
If you would like to be contacted by GMaP prior to your submission, or to be connected to a CRCHD Program Officer, please let us know here. Thank you for taking the time to share this information. We wish you a successful submission!
Yes
No
Clear selection
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