ASPIRE Application

ASPIRE Application

Summer 2025 Program Dates: June 16th - July 25th, 2025

Applicant Details

Student First Name*

Student Last Name*

Research Mentor Details

Research Mentor First Name*

Research Mentor Last Name*

Research Mentor Affiliation*

UCSF Fresno

UC Merced

UCSF SF Campus

Other

Other Mentor Affiliation

Research Mentor Email*

Research Mentor Department*

Additional Research Mentors?

If applicable, please include name(s), email(s), affiliation(s), and department(s)

Mentor Agreement Form*

Has your mentor completed the "ASPIRE Mentor Agreement" form?

Yes

No, but they will before the due date

Research Project Details

Project Title*

Please use the official study name listed on the IRB

IRB Number*

Please ask your research mentor for the IRB number.

If your study does not require IRB approval, please write "N/A"

Research Project Abstract*

Provide a brief description of your research topic

Research Questions/Hypothesis (250 words max)*

Describe the specific research question you will undertake

Background and Literature Review (500 words max)*

Describe the rationale and justification for your research or project through a review of relevant literature and any preliminary studies.

For curriculum design projects only: describe the context that prompted your study, design, development, implementation and/or assessment of curricula, as well as its relevance to literature published in the field

Project Plan (750 words max)*

Discuss the design of your project including appropriate methods and data collection, number and type of subjects, and data analysis strategy.

If research project is community based: Please identify the key partners involved in the project and the roles of each partner. Provide a description of the project and desired outcomes for learners and community based partner(s). Provide a description of the specific preparation that learners and other participants will receive as part of this partnership. Describe the service(s) that UCSF learners will be performing with the community based partner(s). How will learner reflection be structured? Describe how the project will be evaluated. Describe how this partnership project will be sustained after the grant period.

Project Timeline*

Develop a timeline including projected completion dates of your preparations (including animal and human subject’s protocol approvals); travel; preliminary studies; data collection; data analysis; and written product.

Literature Cited*

List references cited in your application above

EPIC Access through UCSF Fresno*

Will you need EPIC access through UCSF Fresno?

Please select ALL that apply.

In-person EPIC Access at UCSF Fresno

Remote EPIC Access at UCSF Fresno

My research project does not require EPIC access/My research project is not based at UCSF Fresno

IRB Approval

If your project requires IRB approval, please confirm that you have been added to the IRB before beggining your research activities

All research activity associated with UCSF must comply with academic and governmental standards regarding the ethical principles and guidelines for the conduct of research involving human or non-human subjects. We recommend that you and your mentor contact the CHR to determine whether your project requires approval. Visit the CHR website here. Read the definition of what constitutes "research" here to answer the question below.

When completing this survey, "identifiable" information includes the following:

· Names

· All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code

· Dates directly related to an individual including birth date, admission date, discharge date

· Phone numbers, fax numbers, email addresses

· Social Security numbers, medical record numbers, account numbers, Certificate/license numbers, vehicle identifiers and serial numbers, license plate numbers

· Device identifiers and serial numbers, Web Universal Resource Locators (URLs), Internet Protocol (IP) address numbers

· Biometric identifiers, finger and voice prints, identifiable photographic images

IRB Approval Required? After reading the definition of what constitutes research, do you believe your project requires IRB approval*

Yes

Confirm IRB Policy*

By checking this box, I understand that if I don't have IRB/CHR approval in place by the beginning of my research/project, I am liable to lose my funding.

Terms and Conditions

Reporting and Programmatic Requirements:

• Funding awards that include a stipend have reporting and programmatic requirements.

• Other requirements may be specified in the award letter.

Confirm Program Requirements*

By checking this box you confirm your acceptance of programmatic requirements. If your project is funded, you will be notified of the source of your funding in your award letter.

Housing/City of Residence

Summer Housing*

Will you need housing in Fresno for the duration of ASPIRE? Shared unit housing can be provided.

Yes, I would like housing in Fresno provided by SJV PRIME

City*

What city will you reside in over the summer?

If you are requesting housing through UCSF Fresno, please write "Fresno"

Send me a copy of my responses

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