NIDDK
NMRI Member Survey
OMB #0925-XXXX
Expiration Date: XX/XXXX
Network of Minority Health Research Investigators (NMRI) Questionnaire

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*). Do not return the completed form to this address.
Please take a moment to answer these questions that will help make the Network more helpful for all members.

As a member of NMRI you are expected to seek the opportunity to participate in the NMRI mentorship program for at least one calendar year. This survey will help to identify how you can participate in this program.  

Returning to Edit Questionnaire   If you are returning and would like to make changes to your Questionnaire answers, click here.
Name:
Address:
Email:  
Phone:
1. What is your highest degree?
What year did you reach your highest degree?  
2. What is your current status?




Other: 
What year did your begin your current status?  
3. What year did you become a member of the NMRI:  
What was your status at that time?




Other:
4. Are you tenured?
If Yes – indicate year this began  
If No – are you tenure track?
If Yes – indicate year this began  
5. How did you become informed about the NMRI?

Other:
6. How often have you attended the NMRI meetings?

X = number of meetings attended:  
Year Last Attended:  
7. Are you planning to attend a future NMRI meeting? If no proceed to # 13
8. What motivates you to attend the NRMI meeting? (check all that apply)






Other:
9. On a scale of 1-10, with 10 being the most opportunity for professional growth, rate your professional development associated with attending the annual NMRI meetings:
Indicate the most important ways that NMRI has helped you in your career development Also, indicate if any grants or publications have resulted:




Other:
Have any grants or publications have resulted:
If you are tenured, give up to three specific examples of how NMRI has contributed to supporting your tenure process



10. Have you participated in the NMRI mentorship program?
11. All NMRI members are encouraged to be mentors. Please list 3 or more areas of research interest, expertise, or special assistance that you are willing to share with another NMRI member.







12. If you are interested in working with an NMRI mentor for one year and documenting your progress, please list which field, area of expertise, or technique you are seeking assistance with







13. If you are not planning to attend a future NMRI meeting, please state why.
14. List other national or regional meetings that you have attended over the past year.
If you elected to attend another national or regional meeting instead of the NMRI meeting explain why.
Please provide other comments.
[Note: If you are submitting your CV and this contains the following information, you may skip to question 19]
15. List all grants submitted since April 2002, and indicate the year of first submission and the year of funding, if funded.
  Grant Year of First Submission Funding Year


 (YYYY)

 (YYYY)
 
16. List the 5 most important oral or podium presentations since April 2002







17. List the 5 most important poster presentations since April 2002







18. List the 5 most important manuscripts since April 2002







19. Final comments
Please submit your current CV (PDF, DOC, RTF, or TXT please)