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CTSI Scholars Program Application Form

Returning?

A A A

Please complete the application and upload all necessary application material.

IMPORTANT NOTICE: New applications are being accepted.

Application Timeline:

Deadline: 8/29/2025 at 5PM EST

Award Announcement: 11/1/2025

Award Period Start: 1/1/2026

If you have any questions, contact Claudia Galeano and Mikhailia Boyd.

The CTSA Scholars Program webpage provides additional information about the program, as well as application materials and instructions.

NOTE: If you are unable to complete this form at one time, scroll to the bottom of this page and click the "Save and Return Later" button. You will be given a Validation Code, which you will need to return and continue the application. Please make sure to copy and write down the validation code for future reference.

Date:

* must provide value

M-D-Y

Project Title:

* must provide value

Do you currently have a K or R-level grant proposal submitted or under review at any NIH institute or center?

Yes No

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First Name:

* must provide value

Last Name:

* must provide value

Middle Initial:

* must provide value

eRA Commons Username (if applicable):

Kerberos Username (if applicable):

Other Current School or Institutional ID: (e.g. Washington Square):

Gender:

* must provide value

Male

Female

Do not wish to provide

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Please specify

Birth Date

* must provide value

M-D-Y

Citizenship:

US Citizen

Permanent Resident

Other

Prior School:

* must provide value

Prior Academic Program:

* must provide value

Degree Received (e.g. PhD, EdD)

* must provide value

Graduation Date (mm/yyyy):

* must provide value

Current Institution:

* must provide value

Please specify:

Current Position:

* must provide value

Department/Division:

* must provide value

Highest Degree Obtained:

* must provide value

Date degree was received (mm/yyyy)

* must provide value

Home Address:

* must provide value

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Work Address:

* must provide value

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Mobile Phone Number:

* must provide value

Work Phone Number:

* must provide value

Preferred Email Address:

* must provide value

Work Email Address:

* must provide value

Are you Hispanic (or Latino)?

* must provide value

Yes

Do not wish to provide

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What is your racial background?
(Please check all that apply)

* must provide value

American Indian/Alaska Native

African American

Asian

Hawaiian/Pacific Islander

White

Other

Do not wish to provide

If other, please specify:

Do you have a disability?

* must provide value

Yes

Do not wish to provide

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If yes, which describes your disability?

Hearing

Mobility/Orthopedic

Visual

Other

Do not wish to provide

If other, please specify:

* must provide value

Are you from a disadvantaged background?
(Applies to high school and undergraduate trainees only)

Yes

Do not wish to provide

reset

Individuals from disadvantaged backgrounds, defined as those who meet two or more of the following criteria: 1. Were or currently are homeless 2. Were or currently are in the foster care system 3. Were eligible for the Federal Free and Reduced Lunch Program for two or more years 4. Have/had no parents or legal guardians who completed a bachelor's degree 5. Were or currently are eligible for Federal Pell grants 6. Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child 7. Grew up in one of the following areas: a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer, or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas

Proposed Faculty Mentors:

* must provide value

Mentors' Email Address:

* must provide value

Mentors' Kerberos Username (if applicable):

NIH Biosketch (new format, limit of 5 pages). See sample attached.

Attachment:BiosketchSample.docx

Applicant's NIH Biosketch

* must provide value

Upload file

Primary Mentor's NIH Biosketch

* must provide value

Upload file

Secondary Mentor's NIH Biosketch

Upload file

An essay of no more than 500 words (11 point Arial font, .05" margins) describing:
1) Your reasons for seeking advanced training in translational research;
2) Your career plans following completion of the program.

* must provide value

Upload file

Scholar Individual Development Plan (Sample)

Attachment:CTSI_K12_Scholar_IDP_Template.docx

An individual development plan for the 2 years of the K12 award, including milestones agreed upon by you and your mentor (see example)

* must provide value

Upload file

A research plan of no more than 3 pages (11 point Arial font, 0.5" margins), including one page describing the project specific aims, and one to two pages providing its clinical and translational impact with regard to the clinical and translational science spectrum (T1-T4) and its innovation. A bibliography should be provided, but will not count against the page limit. The K12 committee reserves the right to request additional information about the project, should such information be needed to make a decision.

* must provide value

Upload file

A letter from your proposed primary research project mentor (must be a full-time member of the faculty or research scientist at NYU), addressing your potential to become an independent investigator and your mentor's track record of successful mentoring.

* must provide value

Upload file

A second letter of recommendation addressing your potential to become an independent investigator from someone who is familiar with your work.

* must provide value

Upload file

A letter from your Dean, Department Chair, or Division Chief indicating:
1) His or her support of your application
2) That you will have at least 75% of your time available for coursework and/or research during the two or more years of the program with no more than ten (10) hours per week in unrelated teaching and/or clinical work.

* must provide value

Upload file

Upload a recent photograph.
Please note that providing a picture is optional. Any pictures submitted will be used solely for announcing awardees or for any post-application materials. Your privacy and preferences are important to us, and we will not use your picture for any other purpose without your explicit consent. Thank you for your understanding.

Upload file

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