K & R Grant Writing Series Questionnaire Question Title * 1. Name: First Last Question Title * 2. Email: Question Title * 3. Please Specify your Title Question Title * 4. Please Specify your Department Question Title * 5. Are you planing to submit a grant within the next 6 to 12 months? Yes, K-Series Yes, R-Series Yes, Other No Other (please specify) Question Title * 6. Have you been awarded an R01? Yes No Question Title * 7. If applying for a Career grant, do you have a primary mentor identified? Yes No Not Applicable (not applying for a K-Award) Please specify who: Question Title * 8. Have you discussed your intentions to apply for a Career Award with your mentor? Yes Not yet Not Applicable (not applying for a K-Award) Question Title * 9. Do you have at least 2 publications in your respective research area? Yes No Question Title * 10. In the space provided, please write separately your primary research question and hypothesis that will be the focus of your grant proposal. Identify 1) Research Question 2) Hypothesis: Question Title * 11. Do you have specific aims and preliminary data to support your hypothesis Yes No, Not yet Please provide an explanation if desired: Question Title * 12. Please send an NIH-style Biosketch or 2-page CV to the following email adress: Dr. Shaweta Gupta: sg98@buffalo.edu I understand and will send a biosketch by May 25, 2016 Done