Form 1 Registration form screenshot

GRADUATE & PROFESSIONAL SCHOOL FAIR - 2022 EXHIBITOR REGISTRATION

OMB Number: 0925-0740

Expiration Date: 31 Jul 2022
The 2022 National Institutes of Health Graduate & Professional School Fair will be held from Tuesday, July 19
through Thursday, July 21. By completing this survey, you are letting us know that you plan to exhibit.
Selecting a date at this time is not a commitment for that date, it is for our planning purposes. In early May,
exhibitors that RSVP will be given additional instructions and information on scheduling. We will include your
meeting information on our webpage and share a compiled list of meeting information with registered
students and NIH postbacs.

This fair will provide an opportunity for representatives of graduate and professional schools to meet and
recruit up-and-coming young scientists taking part in the NIH Postbaccalaureate Program and other college
and university students. Student interest is highest in the following schools/programs: medical school,
graduate school (PhD programs in all the biomedical sciences), MD/PhD programs, public health programs,
psychology, dental school, nursing school and pharmacy school.

Questions?

Jackie Newell-Hunt

NIH Office of Intramural Training & Education

newellj@mail.nih.gov

Web: https://www.training.nih.gov

PRIMARY POINT OF CONTACT (POC) FOR THIS REGISTRATION 
Title*

First Name (Given Name):*

Last Name (Family Name):*

Position Title:*

Email Address (check accuracy):*

We cannot guarantee your participation if you fail to provide a functioning email address. A confirmation
email message containing this registration will be sent to the email account listed within 2-hours of
submission.
Phone Number:*

ex: 123-456-7890

SECONDARY POINT OF CONTACT (POC) FOR THIS REGISTRATION 
Title - Secondary:

First Name (Given Name) - Secondary:

Last Name (Family Name) - Secondary:

Position Title - Secondary:

Email Address (check accuracy) - Secondary:

We cannot guarantee your participation if you fail to provide a functioning email address. A confirmation
email message containing this registration will be sent to the email account listed within 2-hours of
submission.
Phone Number - Secondary:

ex: 123-456-7890

INSTITUTION / UNIVERSITY INFORMATION 
Institution or University Name (complete name):*

Program or Department you are representing (complete name):*

Program Website (include http:// or https://):*

Name of the training program as it will appear in the event program, limit 100 characters, be specific.
We will not insert your university name if you omit it. We recommend that you list the university first.
If you attended last year, you will be able to find the name of your program at
https://www.training.nih.gov/gp_fair_institutions.*

Example: "University of Alabama Dental School" or "Baylor University Graduate Program in Biophysics"
This registration is for which type of program?*

Select all that apply.
Dental

Graduate

Medical

MD/PhD

Pharmacy

Psychology

Public Health

Nursing

Other

If you selected "Other" for the Registration Type, please specify in the space provided:

ONLINE MEETING INFORMATION 
Preference of Online Exhibit Meeting - Date:

(This is not a commitment.)
Preference of Online Exhibit Meeting - Duration:

(This is not a commitment.)
Who will represent your program?

Recruiters / Administrators

Program Directors

Faculty Members

Current Students

NIH Postbac Alumni

Others

What will be your online meeting format?

Questions & Answers

Presentation Shorter than 30 min

Presentation Longer than 30 min

Breakout Rooms

Other

Collection of this information is authorized by The Public Health Service Act, Section 410 (42 USC 285).
Rights of participants are protected by
The Privacy Act of 1974. Participation is voluntary, and there are no
penalties for not participating or withdrawing from the study at any time.
The information collected in this
study will be kept private to the extent provided by law. Names and other identifiers will not appear in any
report of the study. Information provided will be combined for all participants and reported as summaries.
Public reporting burden for this collection of information is estimated to average 15-minutes per
submission. An agency may not conduct or sponsor, and a person is not required to respond to, a collection
of information unless it displays a currently valid OMB control number. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974,
ATTN: PRA 0925-0740. Do not return the completed form to this address.

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