MSIP Fellows - Application Form

MSIP Fellows - Application Form

Applications Due August 23, 2024 (11:59 pm ET)

Please fill out the following application form to officially apply to the MSIP Fellows Program.

We will do our best to notify you if your application is missing required information, however, please double check to make sure your form has ALL the information requested. Please double check for typos.

For any questions, please reach out to our program manager, Juan Quijano, at MSIP at juan.quijano@mssm.edu.

Program website: https://ip.mountsinai.org/fellows-program/

Full name*

Email*

Phone*

Phone

Address*

Street address, city, state, country, and zip code.

Are you a U.S. citizen?*

This will not impact your eligibility.

Select or enter value

Have you ever been convicted of a crime?*

Select or enter value

Current employment status*

E.g., Full time, part time, unemployed, etc.

Title and Institution*

Example 1: Manager of Business Development at XYZ, Inc.

Example 2: MD/PhD Student at ISMMS

Are you currently employed by Mount Sinai?*

Select or enter value

Are you currently a full-time student?*

Select or enter value

Tech transfer area(s) that interest you the most?*

Select or enter value

How did you hear about the MSIP Fellows Program?*

Please submit the following: 1) Resume, and 2) Letter of Recommendation.*

Please make sure to submit the TWO materials we ask for.

Drag and drop files here or

Assay Questions

Provide thorough and truthful responses to the questions below.

I pledge not to use ChatGPT or any other AI technologies to generate answers for the section below.*

Check the box if you agree.

How have your previous experiences prepared you for this program?*

100 words max.

How will this program contribute to your professional goals?*

100 words max.

What unique perspective or skills do you bring to this program that will enhance the cohort's collective learning experience?*

100 words max.

The program requires a significant time commitment. How do you plan to balance this with your current responsibilities?*

100 words max.

Describe a time when you worked in a project in a challenging environment. What did you learn from this experience, and how will it inform your approach to this program?*

100 words max.

Send me a copy of my responses

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