PART I: General applicant information

Last Name: *

First Name: *

E-mail: *

Institutional Affiliation:

Department or Division (if applicable):

Mailing Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

General Institution URL (e.g. http://www.ucla.edu):

Your individual URL at your institution:

*This is used in part to confirm eligibility; please make certain that this URL is entered accurately.

Position Status:

(1) For tenured or tenure-track faculty applicants:

I have a tenured position at my current institution I have a tenure-track position at my current institution

Enter date of receiving tenure or expected tenure evaluation:

mm/yyyy

(2) For applicants at institutions that do not use tenure but have a similar evaluation process that is used as the basis for promotion:

I have been promoted at my current institution I have not yet but will be evaluated for promotion at my current institution

Enter date of receiving promotion or expected promotion evaluation:

mm/yyyy

(3) For applicants at institutions that do not have a promotion process, describe how your institution evaluates scientific progress and scientist career advancement. (*Note that you may not be eligible for Alliance awards if your institution does not have an evaluation and promotion process similar to tenure) :

0/200

In the terms used by your current institution, write out your current full job title:

If you have an Open Researcher and Contributor ID (ORCID) number, enter it here:

Upload an up-to-date Curriculum Vitae (providing information requested below):

*Please upload in PDF format only

Applicants may upload an NIH-style Biosketch if the “Contributions to Science” section is modified to instead list recent and selected earlier publications in one section, as noted below. It is preferable that your document include the following information:

Professional training and positions held
Honors and awards
Peer-reviewed primary research journal publications . Include all that have been published in the past 10 years, and all or selected publications from earlier than 10 years ago. It is recommended that your name in the author list be emphasized by bold or underlined print, and indicate if you have published under a name that is different from your current name. Publications should be listed chronologically.
Other scholarly activity . Include reviews, books, book chapters, datasets, non-peer-reviewed publications, etc.
Grant support . Include currently active and recently completed (or all past) grant support; include funding agency, type and dates of award, grant title, and a one or two sentence description for each grant. Indicate if any grants are internal to your institution.

Standing NIH study section(s) relevant to your overall research program:

The Alliance has no relationship or affiliation with the NIH, and applications for Alliance awards are not reviewed by NIH study sections; these designations are simply used here as convenient subclassifications of the overall realm of biomedical research.

Instructions: From the pull-down list, select one or more (no more than 3) standing NIH study section that would be appropriate for the disciplines of science in which you conduct your research. A list of standing NIH study sections and their descriptions may be found at:

https://public.csr.nih.gov/StudySections/Standing/Pages/default.aspx.

NIH Study Section

PART II: Specific award information

Alliance award for which you are applying:

Specific discipline for which you are applying (see instructions below):

0/60

The Alliance bestows awards in all areas of biomedical science. The terminology you enter in this box will be used in the title of your award, and so should be appropriate for your discipline without being too broad (e.g., “biomedical science” or “human biology” are both too general) or too narrow (e.g., “kinetics of glucose uptake in response to insulin” is too specific). Examples of appropriate terms include “developmental neuroscience”, “renal physiology”, “cancer therapeutics”, “enzymology”, etc. A reference source for suitable terms can be found in the Tree View of Medical Subject Headings (MeSH) as organized by the U.S. National Library of Medicine (https://meshb.nlm.nih.gov/treeView).

Publication(s) for which you consider yourself to be appropriate for this award (see instructions below):

Enter the citation and PubMed ID (PMID) number (not the PMCID) for each listed publication. Generally, you should be the first, last, and/or corresponding author of each publication; if not, or if your role is not clearly evident (e.g., in cases of co-first authorship), explain in more detail in the text box.

If the paper has been published but the PMID number is still pending, enter “Pending” in the text box.

If the paper has not yet been published, it cannot be considered as the basis for an Alliance award, please wait until it has been published.

You may enter up to five publications that establish your qualifications for an award; all should be relevant to the specific discipline that you entered in the text box above.

For the Franklin Prize, these publications may go as far back in time as you like, as it is intended to recognize general and cumulative scholarship in a specific discipline.

For Young Faculty Award applicants, publications from a training period may be included but at least one publication must represent work done from an independent position.

For the AABS Breakthrough Award, applicants should only enter publications (one or more) that are conceptually related and were all published within three years of the application date.

(Optional) In the text box below, provide any further information that you feel is relevant to the evaluation of your application for an Alliance award. Applicants for an AABS breakthrough Award should provide here a brief description of why the chosen publication(s) represent a scientific breakthrough.