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UCSF-Gladstone Center for AIDS Research (CFAR)

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Degree(s) Make sure to add a ", " before the first degree, i.e. ", PhD, MD"

Title/Affiliation Use format: Title, Institution, e.g. Co-Director, UCSF Center for AIDS Research or United States Global AIDS Coordinator, United States Department of State

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NIH- and UCSF-Specific Information

We are required to report this limited demographic information to NIAID for all CFAR program participants, including grantees, mentors and mentees, core service users, committee members, and event attendees. It will be treated as confidential by our staff.

Demographic Information *

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Identify as: African American, Alaska Native, American Indian, Hispanic, Native Hawaiian, Pacific Islander

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I have received direct NIH funding as a PI or PD (CFAR funding is excluded) *

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I have direct received NIH funding at the R01 or R01-equivalent level (R01 equivalents include R01, R23, R29, R37 and, after 200 *

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No

Check all that apply: *

I have been the PI on an R01 equivalent grant in HIV/AIDS

I have been the PI on an R01 equivalent grant in areas other than HIV/AIDS

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We request either the link to your CTSI Profile or you 9 digit UCSF employee ID so we can connect your profile to the UCSF Profiles system.This will automatically pull in your department, location, and other information. Leave blank if you are not a UCSF employee or do not have a CTSI Profile

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UCSF Employee ID

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