Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Document
Requirement
Page
Limit
None
Referees
3 select Referees must upload letters via their eRA Commons account before the grant
deadlines. For detailed instructions, see
https://public.era.nih.gov/commons/public/reference/submitReferenceLetter.do?mode=new
Sponsor and CoSponsor (s)
Identify a sponsor who will mentor and supervise the proposed mentored training and
research experience. The primary sponsor should be an active investigator in the area of
the proposed research training and be committed both to the applicant’s research training
and to direct supervision of his/her research. The sponsor must document the availability
of sufficient research funds and facilities for high-quality research training. The sponsor, or
a member of the sponsor team, should have a successful track record of mentoring
predoctoral students. Applicants are encouraged to identify more than one sponsor, i.e., a
team of sponsors, if this is deemed advantageous for providing expert advice in all aspects
of the research and training program. In such cases, one individual must be identified as
the primary sponsor who will coordinate the applicant’s research and training program.
The applicant must work with the sponsor(s) in preparing the application.
None
Introduction to
Application (if
applicable)
Specific Aims
Resubmission/Revision applications only
1
State concisely the goals of the proposed research and summarize the expected outcomes
including the impact that the results of the proposed research will exert on the research
fields involved.
1
Research Strategy
Applicants must describe a well-defined research project (typically hypothesis-driven) that
is well-suited to his/her stage of career development. The applicant should describe the
background leading to the proposed research, the significance of the research, the
research approach (design and methods) for achieving the Specific Aims, the rationale for
6
Complete?
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Protection of Human
Subjects
the proposed approach, potential pitfalls, and expected/alternative outcomes of the
proposed studies. It is beneficial to include pertinent preliminary data to demonstrate
feasibility.
For research that involves human subjects but does not involve one of the six categories
of research that are exempt under 45 CFR Part 46, the committee will evaluate the
justification for involvement of human subjects and the proposed protections from
research risk relating to their participation according to the following five review criteria:
1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the
subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety
monitoring for clinical trials.
No
limit
For research that involves human subjects and meets the criteria for one or more of the
six categories of research that are exempt under 45 CFR Part 46, the committee will
evaluate: 1) the justification for the exemption, 2) human subjects involvement and
characteristics, and 3) sources of materials. For additional information on review of the
Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.
Inclusion of Women
and Minorities
When the proposed project involves human subjects and/or NIH-defined clinical research,
the committee will evaluate the proposed plans for the inclusion (or exclusion) of
individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or
exclusion) of children to determine if it is justified in terms of the scientific goals and
research strategy proposed. For additional information on review of the Inclusion section,
please refer to the Guidelines for the Review of Inclusion in Clinical Research.
No
limit
Inclusion of Children
Provide a description of the plans to include children, including ages to be included or
excluded from the proposed research and present an acceptable justification for the
exclusion.
No
limit
Vertebrate Animals (if
applicable)
Describe proposed use of animals in the work outlined in the Research Strategy. Justify use of
animals and provide information on the veterinary care of the animals
No
limit
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Project Summary
/Abstract
No more than 30 lines of text. State the application’s broad, long-term objectives and specific
aims making reference to the health relatedness of the project ( i.e., relevance to the mission
of the agency)
1 page
Project Narrative
3 sentence maximum. Describe relevance of this research to public health. Be succinct and
use plain language that can be understood by general, lay audience
1 page
Bibliography and
References Cited
Provide bibliography of any references cited in the Project Narrative. When citing articles that
fall under the Public Access Policy, were authored or co-authored by the applicant and arose
from NIH support, you must provide the NIH Manuscript Submission reference number or
PubMed Central (PMC)/ PMCID number. Citations not covered by the Public Access but are
publicly available , provide URL or PubMed number
No
limit
Facilities & Other
Resources
Identify the facilities (laboratory, animal, computer, office, clinical, and other). If appropriate,
indicated their capacities, pertinent capabilities, relative proximity and extend of availability
to the project. Describe only those resources directly applicable to the proposed work.
No
limit
Equipment
List major items of equipment already available for this project, and if appropriate, identify
location and pertinent capabilities
No
limit
Cover Letter
Applicants are encouraged to include a cover letter. This letter should include the 1)
application title, 2) Funding Opportunity number, 3) Request of assignment to particular
awarding component, 4) List of individuals who should NOT review your application and why,
5) Disciplines involved-if multidisciplinary, 6) If late, explain why, 7) If changed/corrected
application, explaining why you are submitting the changed/corrected application, 8)
Explanation of any subaward budget components that are not active for all periods of the
proposed grant, 9) Statement you have attached any required agency approval
documentation for the type of application submitted (over $500,000 or agency approval)
1 page
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Respective
Contributions
Describe the collaborative process between you and your sponsor/co-sponsor in the
development, review, and editing of this research training plan. Discuss the respective roles
in accomplishing the proposed research.
1 page
Selection of Sponsor
and Institution
Describe the rationale/justification for the selection of the sponsor and institution. 1. Explain
why the sponsor, co-sponsor (if any), and institution were selected to accomplish the
research training goals. If the proposed research training is to take place at a site other than
the sponsoring organization, provide an explanation here. 2. Doctorate or Current Institution.
(For postdoctoral and senior fellows only) Since training is expected to broaden a fellow's
perspective, postdoctoral fellowship applicants requesting training at either their doctorate
institution or at the institution where they have been training for more than a year must
explain why further training at that institution would be valuable. Individuals applying for
Senior Fellowships who are requesting training at the institution at which they are employed
should provide a similar explanation. 3. Foreign Institution. If you are proposing a research
training experience at a foreign institution, show that the foreign institution and sponsor
offer special opportunities for training that are not currently available in the United States.
Key factors in the selection of a foreign institution should be described. If applicable, the
need for and level of proficiency in reading, speaking, and comprehending the foreign
language should be addressed. Save this information in a single file in a location you
remember.
1 page
Responsible for
Conduct of Research
All applications must include a plan to fulfill NIH requirements for instruction in the
Responsible Conduct of Research (RCR). The plan must address the five, required
instructional components outlined in the NIH policy: 1) Format - the required format of
instruction, i.e., face-to-face lectures, coursework, and/or real-time discussion groups (a
plan with only on-line instruction is not acceptable); 2) Subject Matter - the breadth of
subject matter, e.g., conflict of interest, authorship, data management, human subjects
and animal use, laboratory safety, research misconduct, research ethics; 3) Faculty
Participation - the role of the mentor(s) and other faculty involvement in the instruction;
4) Duration of Instruction - the total number of contact hours of instruction; and 5)
1 page
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Frequency of Instruction – instruction must occur during each career stage and at least
once every four years. Document any prior instruction during the applicant’s current
career stage, including the inclusive dates instruction was last completed. See also NOTOD-10-019. Applications lacking a Plan for Instruction in the Responsible Conduct of
Research will not be reviewed.
Goals for Fellowship
and Career
Discuss how the proposed research project and activities enhance the applicant’s
development and relate to the applicant’s career goals as a productive, independent
research scientist. Discuss how the proposed research training plan will enhance his/her
knowledge and technical and professional skills, and facilitate his/her transition to the
next career stage.
1 page
Activities Planned
under this Award
The applicant’s research training plan, i.e. the activities planned under this award, should
be individually tailored and well integrated with his/her research project. Describe the
skills and techniques that the applicant intends to learn as well as any planned, nonresearch activities (e.g. those relating to professional development) during the award
period. The applicant should provide a timeline for the proposed research training and
related activities
1 page
Doctoral Dissertation
and Research
Experience
Summarize your research experience in chronological order. Advanced graduate students,
who have (or will have) completed their comprehensive examinations by the time of award
must also include a narrative of their doctoral dissertation (may be preliminary). If you have
no research experience, list other scientific experience. Do not list academic courses. In
summarizing their research experience, Postdoctoral and Senior Fellowship applicants should
include the areas studied and conclusions drawn. Postdoctoral fellowship applicants should
also specify which areas of research were part of their thesis or dissertation and which, if any,
were part of a previous postdoctoral project.
2
pages
Sponsor and CoSponsor Information
The sponsor(s) should describe their current research support and how this support
relates to the applicant’s proposed research project. A contingency plan should be
6
pages
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
provided that describes how the applicant’s research training will be supported should
there be a gap in the sponsor’s funding during the proposed award period. The role of the
sponsor in the integrated research and training plan should be described. If a team of
sponsors is proposed, this plan should describe the role of each sponsor and how they will
communicate and coordinate their efforts to mentor the applicant effectively.
Sponsor Biosketch
The training plan should be individualized for the applicant, keeping in mind the
applicant’s strengths and any gaps in needed skills, and should be designed to enhance
research training. The training plan should be coordinated with the applicant’s Research
Strategy. The training plan should outline and justify new training opportunities, any
relevant coursework, and professional development activities. Training in professional
development skills, e.g. grant-writing and presentation skills, is strongly encouraged. The
training plan should have the potential to facilitate the applicant’s transition to the next
stage of his/her career
Use new format. See https://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-024.html
Co-Sponsor(s)
Biosketch
Fellow Biosketch
Use new format. See https://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-024.html
Additional
Educational
Information
Describe the graduate program in which the applicant is enrolled, e.g. the structure of the
program, required milestones and their usual timing (number of courses, any teaching
commitments, qualifying exams, etc.), and the average time to degree over the past 10 years.
Describe the progress/status of the F31 applicant in relation to the program's time line.
Describe the frequency and method by which the program formally monitors and evaluates a
student's progress. This information is typically provided by the director of the graduate
program or the department chair. Include the name of the individual providing this
information at the end of the description.
Use custom biosketch. See sample below
5
pages
5
pages
5
pages
5
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
applicant's courses and grades must be included in the Fellowship Applicant Biographical
Sketch, and NOT in this attachment.
Additional Educational Information”
Planned Enrollment
Report
When conducting clinical research, this table should be completed and accompany the
application
1 page
Cumulative Inclusion
Enrollment Report
When conducting clinical research, this table should be completed and accompany the
application
1 page
Separate
attachment
(see sample)
Separate
attachment
(see sample)
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
OMB No. 0925-0001 (Rev. 08/12 Approved Through 8/31/2015)
APPLICANT BIOGRAPHICAL SKETCH—Instructions
(see below for Actual Predoctoral Sample)
Use only for individual predoctoral and postdoctoral fellowships, dissertation research grants (R36),and Research Supplements to Promote Diversity in Health-Related Research
(Admin Suppl). DO NOT EXCEED FIVE PAGES.
NAME OF APPLICANT:
eRA COMMONS USER NAME (credential, e.g., agency login):
POSITION TITLE:
EDUCATION/TRAINING (Most applicants will begin with baccalaureate or other initial professional education, such as nursing.
Include postdoctoral training and residency training if applicable. High school students should list their current institution and
associated information. Add/delete rows as necessary.)
INSTITUTION AND LOCATION
DEGREE
(if applicable)
START DATE
MM/YYYY
END DATE
(or expected end
date)
MM/YYYY
FIELD OF STUDY
NOTE: The Biographical Sketch may not exceed five pages. Follow the formats and instructions below.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
A.
Personal Statement
Briefly describe why you are well-suited to receive the award for which you are applying. The relevant factors may include aspects of your
training; your previous experimental work on this specific topic or related topics; your technical expertise; your collaborators or scientific
environment; and your past performance in this or related fields (you may mention specific contributions to science that are not included in
Section C). Also, you may identify up to four peer-reviewed publications that specifically highlight your experience and qualifications for this
project. If you wish to explain impediments to your past productivity, you may include a description of factors such as family care
responsibilities, illness, disability, and active duty military service.
B.

R36 Applicants (PD/PI) Only:
In addition to the information outlined above, include a description of your career goals and intended career trajectory, as well as your
interest in the specific areas of research designated in the FOA.

Diversity Supplement Candidates Only:
In addition to the information outlined above, include a description of your general scientific achievements and/or interests, as well as
your specific research objectives and career goals. Indicate any source(s) of current funding.
Positions and Honors
List in chronological order all non-degree training, including postdoctoral research training, all employment after college, and any
military service. High school students and undergraduates may include any previous positions. Clinicians should include information
on internship, residency and specialty board certification (actual and anticipated with dates) in addition to other information
requested. This information is used in the reviewing the application and in determining the stipend level for Postdoctoral Fellowships.
State the Activity/Occupation and include start/end dates, field, name of institution/company, and the name of your
supervisor/employer. If you are not currently located at the applicant organization, include your projected position at the applicant
organization as well.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
ACTIVITY/
OCCUPATION
START ENDING
DATE
DATE
(mm/yy) (mm/yy)
FIELD
INSTITUTION/
COMPANY
SUPERVISOR/
EMPLOYER
Academic and Professional Honors
List any academic and professional honors that would reflect upon your potential for a research career and qualifications. Include all
scholarships, traineeships, fellowships, and development awards. Indicate sources of awards, dates, and grant or award numbers.
List current memberships in professional societies, if applicable.
C.
Contributions to Science (for predoctoral students and more advanced candidates only; high school students,
undergraduates, and postbaccalaureates should skip this section)
Considering your level of experience, briefly describe your most significant contributions to science. While all applicants may describe up to five
contributions, graduate students and postdoctorates are encouraged to consider highlighting two or three they consider most significant. These
may include research papers, abstracts, book chapters, reviews, as well as non-publication research products, such as materials, methods,
models, or protocols. For each contribution, indicate the historical background that frames the scientific problem; the central finding(s); the
relevance of the finding(s) to science, technology, or public health; and your specific role in the described work. For each contribution, you may
reference up to four peer-reviewed publications or other non-publication research products (can list audio or video products; patents; data and
research materials; databases; educational aids or curricula; instruments or equipment; models; protocols; and software or netware) that are
relevant to the described contribution. The description of each contribution should be no longer than one half page including figures and
citations. Please also provide a URL to a full list of your published work as found in a publicly available digital database such as SciENcv or My
Bibliography, which are maintained by the US National Library of Medicine. Manuscripts listed as “pending publication” or “in preparation”
should be included and identified. Indicate if you previously used another name that is reflected in any of the citations.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
D.
Scholastic Performance
Predoctoral applicants: Using the chart provided, list by institution and year all undergraduate and graduate courses with grades. In addition, in
the space following the chart, explain any marking system if other than 1-100, A, B, C, D, F, or 0-4.0 if applicable. Show levels required for a
passing grade.
Postdoctoral applicants: Using the chart provided, list by institution and year all undergraduate courses and graduate scientific and/or
professional courses germane to the training sought under this award with grades. In the space following the chart, explain any marking system
if other than 1-100, A, B, C, D, F, or 0-4.0 if applicable. Show levels required for a passing grade.
YEAR
SCIENCE COURSE TITLE
GRADE YEAR
OTHER COURSE TITLE
GRADE
OMB No. 0925-0001 (Rev. 08/12 Approved Through 8/31/2015)
APPLICANT BIOGRAPHICAL SKETCH SAMPLE—PREDOCTORAL FELLOWS
(Note this Sample is for a Predoctoral Fellowship Applicant only and does not include information specific to R36 or Diversity
Supplements. For a Postdoctoral Fellowship Sample, see:
http://grants.nih.gov/grants/funding/424/postdocfellowshipbiosample.docx)
Use only for individual predoctoral and postdoctoral fellowships, dissertation research grants (R36), and Research Supplements to Promote Diversity in Health-Related Research
(Admin Suppl). DO NOT EXCEED FIVE PAGES.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
NAME OF APPLICANT: Leilani Robertson-Chang
eRA COMMONS USER NAME (credential, e.g., agency login): RobertsonL
POSITION TITLE: Graduate Student Research Assistant
EDUCATION/TRAINING (Most applicants will begin with baccalaureate or other initial professional education, such as nursing.
Include postdoctoral training and residency training if applicable. High school students should list their current institution and
associated information. Add/delete rows as necessary.)
INSTITUTION AND LOCATION
Swarthmore College
UC San Diego
A.
DEGREE
(if applicable)
START DATE
MM/YYYY
B.A.
08/2008
END DATE
(or expected end
date)
MM/YYYY
05/2012
Ph.D.
08/2012
05/2018
FIELD OF STUDY
Biology
Molecular Biology
Personal Statement
My long term research interests involve the development of a comprehensive understanding of key developmental pathways and
how alterations in gene expression contribute to human disease. My academic training and research experience to date have
provided me with an excellent background in molecular biology and microbiology. While in high school I was awarded an NIH
Diversity Supplement award to work as a research technician for two summers in Dr. Indira Creative’s lab at the University of Hawaii.
As an undergraduate at Swarthmore College, I conducted research with Dr. Xavier Factor on the mechanisms of action of a new
class of antibiotics. This resulted in a co-authorship publication, as well as an invitation to present a poster at the annual Antibiotica
meeting in Denver, Colorado. For my graduate training at UC San Diego, I have moved into the fields of genetics and biochemistry
by studying the regulation of transcription in yeast, under Dr. Tanti Auguri. Dr. Auguri is an internationally recognized leader in the
field of yeast genetics and has an extensive record for training predoctoral and postdoctoral fellows. Along with giving me new
conceptual and technical training, the proposed training plan outlines a set of career development activities and workshops – e.g.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
public speaking, literature analysis, biomedical ethics, and career options. For my initial project I am currently developing a novel
protocol for the purification for components of large transcription complexes which I hope to submit as a first author publication in the
next few months. As a native Hawaiian, I am the first in my family to graduate from college so I am excited to keep pushing forward
with my education. Overall, I feel that my choice of sponsor, research project, and the training I will get from this fellowship will give
me a solid foundation for my long-term goal to become an academic researcher.
B.
Positions and Honors
ACTIVITY/
OCCUPATION
START
END
DATE
DATE
(mm/yy) (mm/yy)
Lab Technician
(Summers)
06/07
Predoc
08/12
08/08
FIELD
Biology
Present Molecular biology
INSTITUTION/
COMPANY
SUPERVISOR/
EMPLOYER
University of Hawaii
I.M Creative
UC San Diego
Xavier Factor
Academic and Professional Honors
Daughters of Hawaii Scholarship, 2008
National Merit Scholarship, 2008-2012
Paula F. Laufenberg award for best senior project in the Biology Department, Swarthmore College, 2012
B.S. awarded with high honors, Swarthmore College, 2012
NIH Diversity Supplement 2007-2008 (Summers)
Memberships in Professional Societies
Sigma Xi
Association for Women in Science
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
C.
Contributions to Science
My contributions to science are organized to reflect the different research projects I have worked on to date, in high school, college, and now in
graduate school.
I. High School Research: I spent two summers doing research in the laboratory of Dr. Indira M. Creative at University of Hawaii,
funded by a NIH Diversity Supplement award. Dr. Creative has developed several new anti-fungal drugs that might protect against
skin infections. Over the course of two summers I set up in vitro cultures of skin cell lines and conducted a wide range of toxicity
assays. We were excited to find that one of the new agents showed almost no toxicity, even at fairly high doses. Dr. Creative is now
testing the drug in animals exposed to different types of fungal infections, including Candida albicans.
Abstracts
Footman, B., Eisser, J.K., Robertson-Chang, L. and Creative, I.M. 1998. Testing XXH for toxicity in vitro. Abstract for poster
presentation, University of Hawaii Research Symposium, Manoa, HI.
II. Undergraduate Research: I was part of a project in the laboratory of Dr. Xavier Factor at Swarthmore College. Dr. Factor’s
laboratory studies the mechanisms of action of antibiotics. During my time in his lab I was looking at how a new antibiotic, Gen Y, is
able to unravel bacterial DNA. The work was particularly exciting because it looks like the mechanism used by Factor Y might be
completely novel, making it a potential candidate for treating patients infected with antibiotic resistant organisms. Dr. Factor was
recently awarded a patent for this new drug.
Research papers
Nieman, P.Y., Robertson-Chang, L., Pearson, K. and Factor, X. 2003. Gen Y: a novel antibiotic with DNA unwinding abilities. Cell.
Mol. Biol. 30: 25-30.
Abstracts
Robertson-Chang, L. and Factor, X. Testing the ability of antibiotic Gen Y to kill Gram-negative bacteria. Abstract for poster
presentation. 2002. Antibiotica annual meeting, Denver, Colorado, September 2002.
III. Graduate Research: My ongoing predoc research is focused on transcriptional gene regulation in Saccharomyces cerevisiae. I
believe the results from my research will likely be highly relevant to human health as they will provide new details into the workings of
complex biological systems, which will allow for further extrapolations into the development of certain diseases and their progression.
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
I am currently developing a novel protocol for the purification for components of large transcription complexes which I hope to submit
as a first author publication in the next few months.
Research papers
Robertson-Chang L and Auguri, T. 2005. A tandem affinity purification tag approach allows for isolation of interacting proteins in
Saccharomyces cerevisiae. In preparation.
Abstracts
Robertson-Chang L and Auguri, T. A tandem affinity purification tag approach allows for isolation of interacting proteins in Saccharomyces
cerevisiae. Abstract for poster presentation, 2004 Yeast Genetics and Molecular Biology Meeting, Seattle, Washington, September 2004.
D.
Scholastic Performance
YEAR
SCIENCE COURSE TITLE
GRADE YEAR
SWARTHMORE COLLEGE
OTHER COURSE TITLE
GRADE
SWARTHMORE COLLEGE
2008
Cellular and Molecular Biology
A
2008
2008
Foundations of Chemical Principles
A
2009
2009
Organismal and Population Biology
B
2009
2009
Omics
B
2010
2009
General Physics I
B
2011
2009
Introductory Chemistry
A
2011
2009
Organic Chemistry I
B
First Year Seminar: Nation and
Migration
Statistics, Probability, and
Reliability
Calculus I
American Literature
Anthropology of Childhood and the
Family
Disease, Culture and Society in the
Modern World
A
A
B
B
A
A
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
YEAR
SCIENCE COURSE TITLE
GRADE YEAR
2010
General Physics II
B
2010
B
2010
Organic Chemistry II
Microbial Pathogenesis and the
Immune Response
Introduction to Cognitive Science
2010
Biological Chemistry
B
2011
Human Genetics
A
2011
Senior Project
A
2011
Bioinformatics
B
2012
Cell Biology
A
2012
Physics in Modern Medicine
A
2012
Genomics and Systems Biology
A
2012
Senior Project
A
2010
A
A
UC SAN DIEGO
2012
Seminar in Genetics
P
2013
Statistics for the Life Sciences
P
2013
Ethics in Biological Research
CRE
2014
Seminar in Physiology & Behavior
P
OTHER COURSE TITLE
GRADE
Department of Psychological and Brain Sciences
NIH Predoctoral Fellowship Checklist (F31)
Except for the scientific ethics course, UC San Diego graduate courses are graded P (pass) or F (fail). Passing is C plus or better.
The scientific ethics course is graded CRE (credit) or NC (no credit). Students must attend at least seven of the eight
presentation/discussion sessions for credit.