NIH Research Project Application - University of Missouri College of Engineering

Name*

First Last

Salutation

Email*

Office Phone

Mobile Phone

Title (Pre-doc, Post-doc, Medical Student, Assistant/Associate/Full Professor, etc.)

Year in program (for pre-docs, post-docs and medical students)

University*

Department

University Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your school an HBCU, Tribal or Community College?

Yes
No

Gender*

Male
Female

Are you a U.S. citizen or permanent resident? (REQUIRED for eligibility)*

Yes
No

Ethnicity*

Upload Curriculum Vitae*

Upload Research statement, including how the research training will help you.*

For pre-docs and post-docs only: We will also need a reference letter supporting your application. Please have the person send their scanned letter directly to BrainMizzou@gmail.com

Please use the space below to provide any other information you wish to share.

NIH Research (BRAIN) Project Application

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