Attachment 15 - eRA Commons Person Profile Data | |||||
Currently Collected on OMB Cleared Forms | |||||
OMB Clearance # 0925-0001 | |||||
Field Name | Req Opt |
Type of Field | LOV or Notes | ||
Name and ID | |||||
Name Prefix | O | Text | |||
First Name | R | Text | |||
Middle Name or Initial | O | Text | |||
Last Name | R | Text | |||
Name Suffix | O | Text | |||
eRA Email | R | Text | |||
ORCID ID | R | Text | Will be a data feed from another system | ||
Prior Name Prefix | O | Text | |||
Prior First Name | O | Text | will be required if a prior name is to be added | ||
Prior Middle Name or Initial | O | Text | User will be allowed to enter as many 'prior names' as they would like | ||
Prior Last Name | O | Text | will be required if a prior name is to be added | ||
Prior Name Suffix | O | Text | |||
IDENTIFICATION | |||||
DOB (Include DNWTP option) |
R | Date | DNWTP check provided | ||
SSN (full or last 4) | O | Text | |||
CITIZENSHIP STATUS | |||||
Citizenship Country | R | LOV | Country List | ||
Status in the United States | R | Radio Buttons | US Citizen or Non-citizen National Permanent Resident of US Non-U.S. Citizen w/a temporary U.S. Visa Non-U.S. Citzen--Not Residing in the U.S. |
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DEMOGRAPHICS | |||||
Gender | R | Radio Buttons | Female Male DNWTP |
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Ethnicity and Race | |||||
Ethnicity | R | Radio Buttons | Hispanic/Latino Non-Hispanic DNWTP |
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Race | R | Checkboxes | American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White DNWTP |
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Disability | |||||
Do you have? | R | Y/N | |||
Type of Disability (Check all that apply) | R | Checkboxes | Vision Hearing Mobility/Orthopedic Other DNWTP |
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TRAINING AND CAREER DEVELOPMENT SPECIFIC DATA | |||||
Non-Deliquency on US Federal Debt? | R | Radio Buttons | No Yes |
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Text Entry field if Yes | Text | ||||
Disadvantaged Background? | R | Radio Buttons | No Yes DNWTP Not Applicable to me (not an undergraduate) |
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EMPLOYMENT | |||||
Add a New Job | |||||
Employer: Select one: | R | ||||
I work in a company or institution outside NIH | Radio Button | When selected an LOV of organizations registered in the eRA Commons is available to select from | |||
I work inside NIH | Radio Button | When selected, a LOV of NIH ICs is available | |||
Start Date | R | Date | |||
End Date | O | Date | |||
Job Title | O | Text | |||
About This Job | |||||
Primary Employment? | R | Checkbox | |||
R | Radio Button | Full-Time Part-Time |
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This is a job working directly for the federal government. | R | Radio Button | Yes No |
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This is a faculty teaching position. | O | Checkbox | If Checked, then the following Academic Rank LOV is used | ||
Academic Rank | O | LOV | Assistant Professor Associate Professor Instructor Other Professor |
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This is an academic administrative position. | O | Checkbox | If Checked, then the following Position LOV is used | ||
Position | O | LOV | Assistant or Associate Dean Chairperson of Dept (or Director) Dean Other President Vice President |
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Addresss & Contact Information | |||||
R | Text | ||||
Phone | R | Text | |||
Street Address Line 1 | R | Text | |||
Street Address Line 2 | O | Text | |||
City | R | Text | |||
State | R | LOV | State List | ||
ZipCode | R | Text | |||
Country | R | LOV | Country List | ||
Reviewer Information | |||||
What address should NIH use to contact you for reviews? | Radio Button | Options: Use my work address Use my home address |
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Provide a different address If checked | |||||
Different Address | |||||
Street Address | R | Text | |||
City | R | Text | |||
State | R | LOV | |||
ZipCode | R | Text | |||
Country | R | LOV | Country List | ||
Home Address | |||||
Street Address | R | Text | |||
City | R | Text | |||
State | R | LOV | State List | ||
ZipCode | R | Text | |||
Country | R | LOV | Country List | ||
Eligibility for Continuous Submission | LOV | LOV updated annually. Current values are: Eligibility Period: 08/16/2012 – 09/30/2013 Eligibility Period: 08/16/2013 – 09/30/2014 Eligibility Period: 08/16/2014 – 09/30/2015 |
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TRAINEE PERMANENT ADDRESS | |||||
Street Address | R | Text | |||
City | R | Text | |||
State | R | LOV | State List | ||
ZipCode | R | Text | |||
Country | R | LOV | Country List | ||
R | Text | ||||
Phone | R | Text | |||
EDUCATION | |||||
Degrees | |||||
Degree Name | R | LOV | See separate Tab for LOV | ||
Degree Text (for Other) | O | Text | |||
Status: | Radio Buttons | ||||
Degree Completed | R | Radio Buttons | w/Corresponding Date Field | ||
In Progress, expected | Radio Buttons | w/Corresponding Date Field | |||
Length of Program (# of Yrs) | O | LOV | 1 - 9 Years | ||
Institution | R | Text | |||
Location (if not in US, indicate city & country) | O | Text | |||
Is this your Terminal Research Degree? | O | Checkbox | |||
Area of Study-Primary | O | Text | |||
Area of Study-Secondary | O | Text | |||
Area of Residency |
O | Text | |||
Residency Date Completed or Expected |
R | Date | |||
System Generated Fields | |||||
Fields used to aid in NI/ESI efforts. All are system-generated but part of the Person Profile | |||||
ESI Eligibility | Yes/No | ||||
End of Eligibility Date | Date | ||||
New Investigator Eligibility | Yes/No | ||||
Appeal Date | Date | ||||
Appeal Outcome | Text | ||||
Standard NI/ESI Eligibility is system calculated. However an exception policy has been implemented. These exceptions are handled via an appeal process. | |||||
Reference Ltrs | |||||
Referee First Name | R | ||||
Referee Last Name | R | ||||
Referee MI Name | O | ||||
Referee eMail | R | ||||
Referree Institution/Affliation | R | ||||
Referree Department | R | ||||
PI Commons User ID | R | ||||
PI Last Name | R | ||||
FOA Number | R | ||||
Reference Letter Confirmation # (if re-submitting) | O |
Degrees LOV in Person Profile | |
AB | BACHELOR OF ARTS |
BA | BACHELOR OF ARTS |
BOTH | OTHER BACCALAUREATE |
BS | BACHELOR OF SCIENCE |
BSN | BACHELOR OF SCIENCE IN NURSING |
DC | DOCTOR OF CHIROPRACTIC |
DDOT | OTHER DOCTOR OF MEDICAL DENTISTRY |
DDS | DOCTOR OF DENTAL SURGERY |
DMD | DOCTOR OF MEDICAL DENTISTRY |
DNSC | DOCTOR OF NURSING SCIENCE |
DO | DOCTOR OF OSTEOPATHY |
DOTH | OTHER DOCTORATE |
DPH | DOCTOR OF PUBLIC HEALTH |
DPM | DOCTOR OF PODIATRIC MEDICINE |
DRPH | DOCTOR OF PUBLIC HEALTH |
DSC | DOCTOR OF SCIENCE |
DSW | DOCTOR OF SOCIAL WORK |
DVM | DOCTOR OF VETERINARY MEDICINE |
EDD | DOCTOR OF EDUCATION |
ENGD | FOREIGN - DOCTOR OF ENGINEERING |
FAAN | FELLOW OF THE AMERICAN ACADEMY OF NURSING |
JD | DOCTOR OF JURIS PRUDENCE |
MA | MASTER OF ARTS |
MB | FOREIGN - BACHELOR OF MEDICINE |
MBA | MASTER OF BUSINESS ADMINISTRATION |
MBBS | FOREIGN - BACHELOR OF MEDICINE AND SURGERY |
MD | DOCTOR OF MEDICINE |
MDOT | OTHER DOCTOR OF MEDICINE |
MLS | MASTER OF LIBRARY SCIENCE |
MOTH | OTHER MASTERS |
MPA | MASTER OF PUBLIC ADMINISTRATION |
MPH | MASTER OF PUBLIC HEALTH |
MS | MASTER OF SCIENCE |
MSN | MASTER OF SCIENCE IN NURSING |
ND | DOCTOR OF NATUROPATHY |
OD | DOCTOR OF OPTOMETRY |
OTH | OTHER |
PHD | DOCTOR OF PHILOSOPHY |
PHMD | DOCTOR OF PHARMACY |
PSYD | DOCTOR OF PSYCHOLOGY |
RN | REGISTERED NURSE |
SCD | DOCTOR OF SCIENCE |
VDOT | OTHER DOCTOR OF VETERINARY MEDICINE |
VMD | DOCTOR OF VETERINARY MEDICINE |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |