First Name

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Last Name

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Email Address

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JHED ID

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Investigator Level

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NIH Independent Investigator (HIV/AIDS R01 funding or equivalent)
NIH Independent Investigator (Non-HIV/AIDS R01 funding or equivalent)
NIH New Investigator (Have received funding as a PI directly from the NIH, but not yet at the R01 equivalent level)
Faculty member with no history of (non-CFAR) NIH funding
Post doc or Research Fellow
Staff
Undergraduate or Graduate Student

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NIH Special Emphasis Category:

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Recipient of a CFAR Faculty Development Award, mentoring or other CFAR services
Recipient of NIH CFAR administrative supplement
Under-represented group in HIV/AIDs research (African-American, Hispanic, Native American, Alaska native, native Hawaiian, Pacific Islander
Women

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Please select the program in which you are reporting your involvement or requesting services

You can select multiple programs.

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Describe what you are requesting assistance with or what services were provided

(i.e. Calculating sample size, locating a particular assay, looking for an exisitng questionnaire, help in recruiting subjects, etc.)

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Are you requesting assistance on a currently funded grant?

If yes, please indicate if it is related to HIV/AIDS and whether it is NIH-funded.

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Funding division (if NIH-funded) or funding source (if non-NIH-funded):

If not currently funded, write "n/a."

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Grant title (if currently funded) or project title (if not currently funded):

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Grant number (if applicable):

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Is there a date that you require assistance by?

(i.e. application deadline, etc.)

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Johns Hopkins Center for AIDS Research Core Service Transaction Form