Award year
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Please download the application instructions and document templates required for your submission. You will be prompted to upload your completed documents as part of your application.
RESEARCH STRATEGY: Only one research strategy document required per application.
CERTIFICATION AND AUTHORIZATION FORM: Only one certification and authorization form is required per application.
BIOSKETCH INSTRUCTIONS AND SAMPLE: Please read the instructions carefully and then download the biosketch template.
BIOSKETCH TEMPLATE: A completed biosketch is required for senior/key personnel only. Alternatively, investigators may upload their Curricula Vitae.
All letters of support should be written by investigators' Department Chairs, Division Chiefs, or other individuals in positions to commit that the applicants will have sufficient protected time in order to conduct the proposed study.At least one letter of support required per application.
Document download section end
Project title
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Project descriptionPlease provide an abstract or brief description of your project (500 words or less)
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RESEARCH STRATEGY:
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CERTIFICATION AND AUTHORIZATION FORM:
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LETTER(S) OF SUPPORT:
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Project information section end
Title or position
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First name
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Last name
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Degree(s)
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Check all graduate degrees that apply
Degree(s), other
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Primary affiliation
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Tufts Medical Center Tufts University
School or center
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Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
School or center, other
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Department
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If your organization does not have a department, simply input n/a.
Academic rankPlease specify your academic rank, if applicable.
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Distinguished Professor/Distinguished Clinical Professor Professor/Clinical Professor Associate Professor/Clinical Associate Professor Assistant Professor/Clinical Assistant Professor Lecturer Instructor Adjunct Professor Other Not Applicable
Academic rank, other
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Email addressPlease provide email address associated with your primary affiliation.
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Phone numberPlease provide phone number associated with your primary affiliation.
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PRINCIPAL INVESTIGATOR'S BIOSKETCH OR CV :
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Number of senior/key collaborators
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0 1 2 3
COLLABORATOR 1 INFORMATION Collaborator's role on the project
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Co-Principal Investigator Co-Investigator Advisor/consultant Other
Collaborator's role, other
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Collaborator's first name
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Collaborator's last name
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Collaborator's degree(s)
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Check all graduate degrees that apply
Collaborator's degree(s), other
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Collaborator's primary affiliation
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Action for Boston Community Development Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Biotechnology Council Massachusetts Institute of Technology Massachusetts General Hospital Institute of Health Professions Museum of Science, Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
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Collaborator's school or center
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Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
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Department
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If your collaborator's organization does not have a department, simply input n/a.
Collaborator's academic rank
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Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's email address
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COLLABORATOR'S BIOSKETCH OR CV:
COLLABORATOR 2 INFORMATION Collaborator's role on the project
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Co-Principal Investigator Co-Investigator Advisor/consultant Other
Collaborator's role, other
* must provide value
Collaborator's first name
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Collaborator's last name
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Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Biotechnology Council Massachusetts Institute of Technology Massachusetts General Hospital Institute of Health Professions Museum of Science, Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
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Department
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If your collaborator's organization does not have a department, simply input n/a.
Collaborator's academic rank
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Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's email address
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COLLABORATOR'S BIOSKETCH OR CV:
COLLABORATOR 3 INFORMATION Collaborator's role on the project
* must provide value
Co-Principal Investigator Co-Investigator Advisor/consultant Other
Collaborator's role, other
* must provide value
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all graduate degrees that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts Biotechnology Council Massachusetts Institute of Technology Massachusetts General Hospital Institute of Health Professions Museum of Science, Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
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Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Department
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If your collaborator's organization does not have a department, simply input n/a.
Collaborator's academic rank
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Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's email adrdress
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COLLABORATOR'S BIOSKETCH OR CV:
Collaborator information section end
APPLICANT CERTIFICATION AND AUTHORIZATION
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I, (as PI), certify that the statements herein are true, complete, and accurate to the best of my knowledge. If a CTRC voucher is awarded, I agree to accept responsibility for scientific conduct of the project, provide the required progress and outcomes reports, and comply with the Tufts CTSI terms and conditions outlined in the request for applications. I also accept responsibility for payment of any and all over-expenditures should they occur as a result of this project. Long-term Outcomes Tracking
Principal investigator's signature
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Please type in your first name and last name.
Principal investigator's signature date
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Today M-D-Y
Please review your information prior to final submission. If you are satisfied with your responses, please click "SUBMIT". You will have a chance to provide your email address to receive a confirmation email.
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voucher@tuftsctsi.org and we will help you return to your unfinished application.
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