BIRCWH Scholars Program Application
DEPARTMENT CHAIR OR DIVISION HEAD STATEMENT (Limit to 1 page)
Name of Chair or Division Head:
Candidate’s Name:
Department:
Email:
1. Specifically describe the role that the candidate will have in your department as a leading force in basic research, translational
research, clinical research and/or health services research relevant to women's health in the neurosciences after completing the
career development program:
2. Please indicate all that you will provide to support the candidate’s research. Be specific as to amount of space, number and kind
of staff, clinical and lab resources, and dollars you will make available to the scholar (this has an important impact on our
funding decision).
I support this proposal for a career development award in basic research, translational research, clinical research and/or health
services research and certify that if he/she is selected as a MUSC BIRCWH Scholar he/she will be able to devote at least ___% effort
to the BIRCWH program, including research carried out in my division/department (this should be based on the entire amount of
time worked in a typical week; fill in 75% unless you’ve negotiated something different.)
I will also support this proposal by providing tuition, fees and books for the MUSC BIRCWH Scholar for the duration of his/her
participation in the BIRCWH whether he/she participates the MSCR program part time or creates his/her own training component
and is considered a full time student. I also acknowledge that the tuition will be based on the NIH NRSA tuition calculation used for
T32s.
Signature:
Date: