NIDDK

Gateways to the Laboratory / NIDDK Honors Research Program

To learn more about NIDDK you may visit our website at http//www.niddk.nih.gov .
All fields marked with a * are required for Final Submission.
Personal Information  
*First Name:
Middle Initial:
*Last Name:
*Date of Birth: Click Here to Pick a Date
*(Permanent Mailing Address) Street 1:
(Permanent Mailing Address) Street 2:
*(Permanent Mailing Address) City:
*(Permanent Mailing Address) State:
*(Permanent Mailing Address) Zip Code:
*Home Phone:
*Cell Phone:
*Email Address:
*Veteran: Yes   No
*Are you a U.S. Citizen: Yes   No
*If no, are you a permanent resident: Yes   No
(Photographic copies of both sides of your Permanent Residency Card are required prior to acceptance to the Program)
*Hispanic: Yes   No
*If yes above, your Nationality:
If Other Nationality, please specify:
*Race:
If Other Race, please specify:
Previous NIH research experience: Yes   No
If YES, what Program:
Other NIH Program: most recent year
Relative at NIH: Yes   No
If yes, relative's employer:
   
Academic Information
(An official copy of your college transcript is required and should be sent from your school to the address below)
*College in which you are enrolled:   
Other Institution:
College Mailing address 2/15 till 5/31:
*Street 1:
Street 2:
*City:
*State:
*Zip Code:
Phone Number at School:
*Current classification:
*Anticipated graduation date (month): *Year:
*Current Cumulative GPA:
*School Grading Scale:
(i.e. 4.0, 5.0, other)
Total Credit Hours (by end of semester):
*Academic Major:
*Coursework: Include coursework currently in progress:
*Resume: Please insert your resume or CV. Include relevant research experience, scientific publications, honors and awards, etc.
   
References (Two Letters of Recommendation are required from individuals who are familiar with your academic abilities and accomplishments. Please have the individual writing your recommendation submit a signed letter directly to the email address, mailing address or fax below.
Reference 1  
*Title:
*First Name:
Middle Initial:
*Last: Name:
*(Permanent Mailing Address) Street 1:
(Permanent Mailing Address) Street 2:
*(Permanent Mailing Address) City:
*(Permanent Mailing Address) State:
*(Permanent Mailing Address) Zip Code:
*Phone:
Fax:
Email Address:
   
Reference 2  
*Title:
*First Name:
Middle Initial:
*Last: Name:
*(Permanent Mailing Address) Street 1:
(Permanent Mailing Address) Street 2:
*(Permanent Mailing Address) City:
*(Permanent Mailing Address) State:
*(Permanent Mailing Address) Zip Code:
*Phone:
Fax:
Email Address:
   
*Personal Statement: Please state your research interest, career goals, and reasons for applying to training at the NIH. If more space is needed please attach a separate sheet. (600 words or less)
COUNT YOUR WORDS!

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NOTICE TO ALL APPLICANTS
  • Students are advised to ensure that all application information is accurate. False or inaccurate information contained in this application may be grounds for denying your candidacy or removing you from the program.
  • Deadline for applications is February 15. However, we encourage applicants to submit their applications ASAP.
  • Additional information for payroll purposes may be requested upon selection.
  • Students should request Letters of Recommendation at least one month in advance to insure timely completion and receipt of the letter. The recommendation provider should mail the letter to the address indicated below. Please download the Letter of Recommendation template.
  • Applications and Letters of Recommendation may be mailed, submitted electronically, or via fax to:

    Ms. Winnie Martinez
    Program Analyst
    Office of Minority Health Research Coordination
    National Institute of Diabetes and Digestive and Kidney Diseases, NIH
    II Democracy Plaza
    6707 Democracy Blvd., Room 906A
    Bethesda, Maryland 20892

    Tel: 301-435-2988
    Fax: 301-594-9358
    Email: MartinezW@mail.nih.gov

  • The receipt of your application will be acknowledged via email.

You can save your information and come back later to complete and finalize using your login and password. Once you press the Submit Final Application button, the application will be forwarded to the review committee and you will be unable to make changes. Remember your login and password are case-sensitive and are only required if you are not ready to submit your Final Application.
*Login:
*Password:
AGREEMENT:  I understand that electronic submission of this application to the NIDDK PI/AN Program indicates that all information provided is accurate and true to the best of my knowledge.  Also, I understand that submission of false or misleading information through this application process is grounds for immediate dismissal from the PI/AN summer research program and/or experience and may result in the forfeiture of any associated benefits and financial support.
I agree:
Date: 2/4/2012