Due October 1, 2024

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* 1. Trainee Name

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* 2. Current Position

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* 3. Mentors

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* 4. Research Project Title

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* 5. Funding Mechanism and amount per year(i.e. NIH K08, VA CDA, Local KL2, Foundation grant…)

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* 6. Honors / Awards (This reporting period)

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* 7. Dollar amount supported from your department
*Please list the dollar amount supported from your department for Lab tech, assistant, travel expenses, equipment, subject reimbursement, animal cost

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* 8. Clinical activities
*What percent effort have you devoted to clinical activities vs. your research over the last year? Do you anticipate any changes in the balance in the coming year?

Publications
  • List any publications (published or in press only) that have occurred in the last year. (If you list something this year as published that you listed last year as “in press”, please make a note of that, so it isn’t counted twice). Cite PMCID numbers for the publications you list. The PMCID is the only way to show compliance for a paper that was published more than three months ago.
  • If a PMCID is not available because the paper is in press or was published within the last three months:
    • Indicate “PMC Journal - In Process” at the end of the citation if the journal will be submitting directly to PMC. (Check this list of journals or confirm your arrangements with these publishers to be sure.)
    • OR, provide an NIHMSID for a manuscript that is still in process in the NIH Manuscript Submission (NIHMS) system. (Be sure to complete the submission process promptly to obtain the PMCID!)
  • If you believe the paper does not fall under the Policy, please provide a brief explanation.

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* 9. Publications

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* 10. Please list any presentations you gave in the last year regarding your research. (include title of presentation, where it took place (city/state) month/year)

Grant Applications
List any grant applications that you have submitted (or been involved in submitting) in the last year. For each grant, please list the following:
a. Title of grant
b. Agency to which you applied
c. Objective/ Goal of project
d. Principal Investigator / your role
e. total budget of the grant
f. your percent effort on the grant and goal of the project
g. Identify whether the grant was funded, rejected, or is still under review.

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* 11. Grant applications that you have submitted (or been involved in submitting) in the last year.

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