P30 UK-CARES: Membership Application

APPROVAL AND EVALUATION PROCESS The Director, Deputy Director, and Executive Committee will vote on the appointment of new nominees and reappointment of existing members. Initial appointment is a term for three (3) years. Prospective UK-CARES members must demonstrate a commitment to the mission and vision of the center and are expected to participate in center events. TYPES OF MEMBERSHIP FULL -UK faculty member who is currently or in the past five (5) years a principal investigator on a National Institute of Environmental Health Sciences (NIEHS) funded grant (including Projects or Cores of NIEHS Program grants and UK-CARES pilot grants), and/or -First or senior author on at least one (1) environmental health science (EHS) focused original research article in a major journal (top tier journals, and/or major EHS journals such as Environmental Health Perspectives, Environmental Research, or Toxicological Sciences) within the last three (3) years ASSOCIATE -Has active EHS-related National Institutes of Health (NIH) grant support, and/or -Co-investigator on an NIEHS grant, and/or -UK faculty member who has research interests that are relevant to one or more of the UK-CARES focus areas, and/or -Actively engaged in UK-CARES activities (e.g., Science Communication Faculty Fellow) COMMUNITY -Actively engaged in UK-CARES activities (e.g., Stakeholder Advisory Board member) -Project director of a UK-CARES funded community grant -Faculty from regional colleges or universities in our target region

Type of Membership

Type of Membership Requested*

Select

Nominator*

Please provide the name of an existing center member who recommended you for membership or enter "self-nominating" in this field.

Applicant Information

First Name*

Last Name*

Degree(s) Held*

Position/Academic Title(s)*

Faculty Rank and Title Series, if at UK

College/Organization*

Department*

Office Phone*

Email*

URL for Research Profile/Lab/Community Organization

Assistant Information

Please enter your assistant's information, if applicable.

Assistant Name

Assistant Email

Assistant Phone

Research Interest(s)

Research Group(s) of Interest*

UK-CARES currently has four (4) research interest groups listed in the dropdown menu below. Please select all that apply.

Select

Core Facilities and Programs*

Check those that you are currently using or might use in the future. Please select all that apply.

Select

Research Interests*

Describe your research interests and how UK-CARES and/or the community can benefit from and/or contribute to your research or community outreach (text box 2000 character limit).

Keywords*

Provide up to five (5) keywords to describe your research or community outreach interests.

Interdisciplinary or Collaborative EH Research*

Provide a list of any interdisciplinary or collaborative environmental health related research or community outreach with other UK-CARES members or other EHSCC members in the U.S. (text box 2000 character limit). If none, enter None to Report or Not Applicable.

Environmental Health Related Funding*

Provide a list of environmental health related funding that you have received within the past five (5) years, including amount, start and end dates, your role (PI, Co-I, consultant), funding source, and grant mechanism (e.g., NCI or NIEHS, R01 or R03; text box 2000 character limit). If none, enter None to Report or Not Applicable.

Environmental Health Related Publications*

Please provide a list of all environmental health related publications within the past three (3) years; include full citation (text box 2000 character limit). If none, enter None to Report or Not Applicable.

Involvement in UK-CARES

Please list your involvement in UK-CARES activities within the past year. Include name and frequency of the activities (e.g., attended two EHS seminars, attended annual Center/EAB meeting in September) (text box 2000 character limit). If none, enter None to Report or Not Applicable.

Curriculum Vitae, Biosketch, or Resume

Please upload a PDF of your most recent CV, biosketch, or resume.

Curriculum Vitae, Biosketch, or Resume*

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse