PCI Fellow Program Applicants - Deadline February 28, 2017

We are very pleased that you have decided to apply to the PCIFellows Program! The application process will already get you started in evaluating technologies.

Please use this form to submit your application. Once submitted the form can not be edited, so please make sure it is correct before doing so. Several documents are required prior to starting the application form. Since we receive a large number of applications we cannot review incomplete ones.

The initial training workshop is absolutely mandatory for all accepted fellows. It takes place Wednesdays June 1, 2016 and June 8 from 9am to 1pm; there is no flexibility. Please do not apply if know you will not be able to attend the training.

Please review carefully the instructions available here:
http://pci.upenn.edu/how-to-apply/










In 50 words or less, tell us something interesting about you




This is the ID that you use to access Penn web sites such as registrar, hr, etc. It is the ID, NOT the password


mm/dd/yyyy















Life sciences candidates should only pick options (2) or (3)



Please indicate the areas where you feel comfortable reviewing scientific publications.



In 50 words or less describe your background and your areas of expertise.




















use this format: xxx-xxx-xxxx















Information on the program you are currently in.






This is when you started your current program. Please provide a date using the format mm/dd/yyyy


This is when your current program is scheduled to end. Write "indefinite" if it has no scheduled end.


if aplicable, provide the name and title of of your advisor or the principal investigator on your project (please provide name, title, and affiliation). E.g., Fancis Seuss, Radiation Oncology


where your program is housed, e.g., CBE, EE, MSE, Pathology, Neuroscience








If you entered "other" name the university or institution where your program is housed


if applicable, provide the title of your research project or thesis.





e.g., B.A., B.Sc., B. Eng


yyyy


e.g., Boston University, Penn, John Hopkins


e.g., History, Biology, Bioengineering, CBE, EE, MSE





E.g. Master in Science, MBA, Ph.D.


yyyy


e.g., Boston University, Penn, John Hopkins


e.g., robotics, bioinformatics, gene therapy





Information about your second graduate degree if you completed one.


e.g. Master in Science, MBA, Ph.D., D. Phil.


yyyy


e.g., Boston University, Penn, John Hopkins


e.g., robotics, bioinformatics, gene therapy





Using the button further below, upload the following documents:
1-a one-page resume,
2-consent forms if required
3-technology assessment
4-statement of interest
5-photograph (jpg format only! provide a 3 inch x 3 inch high resolution head-shot)

(consent forms are available through his page: http://pci.upenn.edu/how-to-apply/)

Add a check-mark next to the documents you uploaded.









Please write here any special remarks you would like to include with your application form.


Attach the two the files indicated in the instructions sheet:
(1) You high-resolution photo named <LastName>_<First_Name>_Photo.jpeg

(2) - your “PCI Fellows Application” named <LastName>_<First_Name>_PCI_Fellows_Application.pdf


Incomplete applications will not be considered.








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