Recommendation Form

Faculty Recommendation Form

We would appreciate your candid evaluation of the student listed below who is applying for the NIH/NCMHD Minority International Research Training Award. Your comments will be held confidential. Your prompt response will be appreciated since incomplete applications will not be evaluated. Please confine your evaluation to this online form. Thank you in advance for your time and cooperation.

Student's Name*
FirstLast
Faculty Member*
FirstLast
Your Faculty E-Mail*
Institution Name*
Institution Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Approximately how long have you known the applicant?
How well are you acquainted with the applicant as a person?*
Please select one
How well are you acquainted with the quality of his or her work?*
Please select one
In which course(s) have you had the applicant as a student?*
Is the student currently in your lab?*
- Yes
- No
If so, will he or she return to your lab after the international research experience?*
- N/A
- Yes
- No
Please Rate the Student By Selecting the Appropriate Areas Below
General Intelligence*
Academic Ability*
Ability to Integrate Information*
Ability for Understanding*
Creativity*
Interest*
Perseverance*
Laboratory Techniques*
Social Adaptability*
Why do you feel that this applicant would benefit from the MHIRT program?*
The purpose of the MHIRT program is to broaden cultural perspectives and encourage gifted minority students to consider a research career in the biomedical/behavioral sciences by entering a doctoral degree-granting program. The long-term goal of MHIRT is to increase minority faculty representation in the biomedical sciences.
To your knowledge, are there any special circumstances—financial, social, or otherwise—which you believe require consideration?*
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By re-typing your name and date at the end of this form, you certify that the information in this application is correct to the best of your knowledge and belief.
Name*
FirstLast
Date*
MM
DD
YYYY
Just to Verify You're Human

On behalf of the MHIRT Directors, thank you for taking the time to complete the recommendation.

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Recommendation Form

Faculty Recommendation Form

Please Rate the Student By Selecting the Appropriate Areas Below

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