NLM Training Program: Mentor Recommendation Form

NLM Training Program: Mentor Recommendation Form

First Name
Academic Title
Middle Name
Primary Department or Program
Last / Family Name
Institution
Email
Telephone
Applicant's First Name
Middle
Applicant's Last Name
Are you the Primary or Secondary Mentor
  • - select a option -
  • Primary
  • Secondary
Applicant Level
  • - select a option -
  • Predoctoral
  • Postdoctoral
Desired Start Date
Applicant evaluation
Please evaluate the applicant's overall ability and likelihood of becoming a productive first quality researcher in this field. Please include a brief statement about your relationship with the applicant, and how long you have known him/her.
Upload your PDF
Please comment on the following specific points, and include the question number in your replies:
1) Does the applicant appear to have a career plan consistent with his/her stage of development? Does it appear realistic, and does the applicant have the ability to achieve it?

2) Please comment on the quality of the applicant's publications, abstracts, or other research presentations and describe the applicant's role in these.

3) Does the applicant have the written and oral presentations skills to communicate effectively in academics, research and professional settings? To work effectively within an interdisciplinary group ? To work with non-technical audiences and groups?

4) How would you rate the applicant's overall academic and intellectual ability including GPA, difiiculty of prior academic work and any recognition received. Has the applicant had to overcome any unusual barriers or difficulties in his/her prior training?

5) How would you rate the applicant's creativity and ability to assilimilate information from a variety of disciplines? Does the applicant have the ability and desire to synthesize new interdisciplinary ideas and concepts?
Upload your PDF
How would you rate the applicant relative to other trainees you have known at comparable stages of development in terms of overall potential for an interdisciplinary research career: top 1%, top 5%, top 10%, top 25%, or top 50%?
Primary Mentors must provide current support information.
CCBTP postdoctoral fellows receive NIH scale stipends (up to Level 3) based on years of postdoctoral experience. This sum may not be supplemented by federal funds. Partial actual costs for fringe and health insurance are supplied.

For each grant, provide funding agency, project title, grant number, the total award period and ANNUAL DIRECT costs.
Upload your PDF

Contact Information for Primary Mentor's Department Administrator

First Name
Email Address
Last Name
Phone