Clip this form
to the signed original of the application after the Checklist. Do not duplicate.
All applicants
must complete Section I, Items A and B; senior applicants also should complete
Item C, providing requested salary/stipend budgetary information. Pre- and
postdoctoral applicants should complete Item D, providing requested budgetary
information as applicable.
The following
assurances and certifications must be verified by the signature of the
applicant on the Face Page of the application (see Section III.B, Other
Information, beginning on page 331).
Debarment and
Suspension
Delinquent Federal
Debt
Drug-Free Workplace
At least three completed,
sealed references must be submitted with the application or it may be delayed or returned
to the applicant without review.
The instructions
tell referees to complete the form and return it in a sealed envelope to the
applicant as soon as possible. Applicants should remind referees that their
reports should be provided on the form and any continuation pages. Applicants
are asked not to open the envelopes to ensure the confidentiality of such
information. The sealed envelopes must be attached to the original application.
Applicants submitting a revised application or a competing continuation
application also must submit these reference forms.
Referees should
be carefully selected. Only those individuals who can make the most meaningful
comments about the applicant's qualifications for a research career should be
used. The sponsor of this application cannot be counted as a reference. The
sponsor's recommendation is included as part of the application (Item 36).
Where possible, select at least one respondent who is not in the applicant's
current department. If not submitting a reference from the dissertation advisor
or chief of service, explain in Item 26. Graduate or medical school respondents
are preferred over those from undergraduate schools (except for predoctoral
applicants).
Request reference reports only from individuals who will be
able to return them in time for submission of the application. Consider any
factor (e.g., illness or extended vacation) that might cause an inordinate delay.
Prospective applicants should send these reference forms to the referees well
in advance of the application submission date.
[TOC] [Changes] [Foreword] [Sections IA-B] [Sections IC-1]
[Section IC-2]
[Section IC-3]
[Section ID]
[Section II]
[Section III]
[Section IV]
[Section V]
[Glossary]