Application Requirements for the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research sponsored by the
Neurofibromatosis Therapeutic Acceleration Program (NTAP) of Johns Hopkins University

Please read these instructions carefully before submitting your application.  If there are any questions, please contact Marigo Stathis (Director of Science Program Management),  mstathi1@jhmi.edu.

All application materials (with the exception of letters of support and the video clip) must be completed and submitted as a single PDF to info@n-tap.org with the subject line entitled “Last,First-FSC- application-documents”. The video clip should be submitted to the same address with the subject line as “Last,First-FSC-application-video”.  Letters of support should be submitted directly by the author to info@n-tap.org with the subject line “Candidate name Last,First-LOS-Mentor name Last, First”. A checklist is included for your convenience (Addendum 1).

The fully completed application and ALL supporting materials (including letters of support, video clip and signature pages) must be received by February 10, 2015 by 11:59 p.m. EST.

Eligibility Requirements

Eligibility criteria for Collins Scholars applicants are as follows:

1.  Hold a health-professional doctoral degree that permits patient care.

2.  Commit 100% of professional effort to the program for a minimum of two years.

3.  Be in the last stages of post-doctoral training or a junior faculty member within seven years of the completion of the last degree earned.

4.  Have a commitment to patient focused research in the field of neurofibromatosis type 1 (NF1).  A redirection in focus from non-NF1 research to NF1-focused research is welcomed, but must be explained by the candidate and mentors.

5.  Demonstrate prior research commitment and accomplishments.

6.  Have a mentorship team that includes research, clinical and career mentorship (these roles can be filled by up to three people) with commitment to the candidate’s training, expertise in the research skill set proposed in the application and in the clinical management of NF1.

7.  Agree to meet all of the requirements of the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research, including participation in all required Collins Scholars meetings and activities.

Application Components

Please include a header with the candidate name “Last, First” as well as page numbers throughout sections I-VII.

I.	Cover sheet with personal information (page 1)
a.  Name
b.  Address
c.   Current position
d.  Current university and department e.  Mail address
f.	Email address
g.  Phone

II.	Professional History (page 2)
Provide information about your prior research and clinical training experiences beyond what is evident in the biosketch. Describe your past scientific experience, indicating how the award fits into your past and future research career development. Please highlight the themes that have guided your previous work.  If your work is changing direction to focus on NF1, explain the reasons for the change. It is important to justify the award and how it will help you develop into a leader in the field of NF1 research and your overall career aspirations.

Personal introduction and mission statement video: Please provide a video clip (up to 2 minutes) in which you discuss your clinical and research focus, the rationale for training in NF1 clinical translational research, why you have potential to be a leader in the NF1 research field and how you will use the time and resources of The Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research to accomplish these goals.

III.	Career Development Plan (3 page maximum)
The career development plan should cover the two-year period of the award (with optional justification for a third year) and discuss how this plan will be extended to ensure ongoing success in NF1 research beyond the time of the award.  Stress the new, enhanced research skills and knowledge you will acquire as a result of being a Collins Scholar.  Describe the structured activities such as coursework, internships, workshops and other formal learning experiences
that will be incorporated into your career development plan. It is important that you discuss
what you will do differently if you are a Collins Scholar compared to your training without the award, specifically in relation to the field of NF1 research. You must include a description of how you will meet the NIH requirements for instruction in the responsible conduct of research (http://grants1.nih.gov/grants/guide/notice-files/NOT-OD-10-019.html).  Finally, you must include a timeline that incorporates all elements of the career development plan, including plans to apply for subsequent grant support to continue your NF1 focused clinical translational research.

IV.	Research Project Description (10 page maximum)
For the Project Description, please use Arial size 12 font. Margins should be 1” on all sides,
10 page limit. References are not included in the 10-page limit.  Applications that do not follow this format will not be considered.

i.	Title
ii.	Technical Abstract:  Describe your proposed research project in 250 words or less. iii.	Lay Abstract: Describe the proposed research project and its significance for
improving outcomes for patients with NF1 for a lay audience in 250 words or less.
iv.	Research Plan: 
a.  Hypotheses and Specific Aims of the project.
b.  Significance  of the problem(s) to be addressed and how the project will improve scientific knowledge and/or change the field of study.
c.   Preliminary Findings that help demonstrate feasibility.  Highlight results that are a result of the candidate’s prior research.
d.  Approach – Describe the overall strategy, methodology, and analyses to be used to accomplish the specific aims of the project, noting in particular how it
is clinical and/or translational.  Please also note the role the research mentor will play in the execution of the research.  Discuss potential problems and alternative strategies.  Detail the milestones and deliverables of the aims and
their associated timeline.  Provide statistical justification for sample sizes for clinical research plans.
e.  Innovation  – Explain how the project challenges current practice or creates a novel approach to the problem and why it has potential to improve outcomes for patients with NF1.

V.	NIH Formatted Biosketches i.  Applicant
ii.  Lead Mentor
iii.  All other members of your mentorship team
i.	Instructions can be found here:
http://www.grants.nih.gov/grants/funding/2590/biosketchsample.pdf
ii.	A blank Biosketch form can be found here:
http://grants.nih.gov/grants/funding/phs398/biosketch.pdf

VI.	Mentorship plan (3 page maximum)
a.  The mentorship plan should cover a two-year period with discussion of the role of the mentors during and after the period of this award.
i.  Research mentorship – discuss which of your mentors will serve as your research
mentor and why they are suited for this role.
ii.  Clinical mentorship – discuss which of your mentors will serve as your clinical mentor and why they are suited for this role. (The research and clinical mentorship can be performed by one person if this is justified).
b.  The mentorship team must consist of at least three members: a lead mentor and two
other mentors.
i.  Lead mentor - this must be the scientific research mentor

•		This person will be a faculty member expert in the candidate’s area of clinical or translational research.  This mentor will guide the development and execution of the research proposal as well as play a key role in the development of your career development plan. Your lead mentor is responsible for:
a.  Guiding and encouraging the design and execution of an original, high quality, clinical or translational research project

b.  Supervising the preparation of a final report
c.   Guiding and supervising the execution of the career development plan
d.  Attending NTAP sponsored events, including a mentor training
program in 2014 and the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research annual meeting.

ii.  At least TWO additional members of the mentorship team shold be identified
•		The two other mentors complete the mentorship team and are expected to provide additional expertise in the scientific area of research chosen for the project (complementary to the interests of the lead mentor). It is advisable that one mentor be within your discipline and one be outside of your discipline, and that at least one mentor be focused on your career development.
•	You must provide the details of how the mentorship team will work together to meet all of the goals of the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research, including their role in designing and securing the success of the research project, securing opportunities for your training in specific areas, oversight of your career development plan and ensuring that you successfully meet the requirements of the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research.  Please include specific details about how the you will communicate with each mentor and
how the mentors will communicate with each other to achieve these goals.

VII.	Signature pages (Addendum 2)
a.  Applicant
b.  Authorized official for the University

VIII.	Letters of Support
a.  Three letters of support are required. These should be addressed to Dr. Jaishri Blakeley and emailed in PDF format by February 10, 2015 11:59 EST to  info@n-tap.org with the
subject line “Candidate name Last,First.LOS.Mentor name Last, First”.

These letters each have a specific area of focus (please see below); however, all letters should comment on the potential for the candidate to be a leader in clinical translational research in NF1, why they are excellent candidates for the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research, and why being a Collins Scholar will secure their successful career in clinical translational science in NF1.

b.  Lead mentor

i.  This letter should highlight why the mentor is suited to serve as the lead mentor for the candidate’s project.  The letter should also include a statement about the mentor’s commitment to providing career development and counseling; guiding and encouraging the design and execution of an original, high quality, clinical or translational research project; supervising the preparation of a final report; and collaborating with the mentorship team to support the Collins Scholar. The mentor should also agree to meet the requirements of the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research including a required orientation session for mentors and attendance of the annual meeting.

c.   A second mentor of your mentorship team.
i.  This letter should detail the role the mentor will play in the candidate’s research project and career development plan and discuss how the mentorship team will be coordinated to ensure the candidate is performing optimally.

d.  Department Chairperson
i.  The letter from the department chairperson should guarantee 100% protected time for research and NF1 focused clinical time for the duration of the award.  It should also include discussion about the role of the candidate in the department, the department’s commitment to the candidate during and after the completion of the award and the resources available to the candidate to further clinical translational science in NF1.

e.	Additional letters of support may be submitted at the candidate’s discretion.

Additional Information

The awarded scholars will be notified in late March, 2015. The position will commence July 1,
2015.

1.  Scholars must attend an annual meeting of the Collins Scholars, the annual Children’s
Tumor Foundation CoNFerence and an annual academic meeting within their specialty.

2.  Scholars and mentors will attend an orientation that will review the specific requirements for clinical translational science training, including didactic course work, exposure to pharmaceutical industry, and regulatory agencies pertinent to their research focus, as well as the additional training and reporting requirements specific to the Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research.

3.  Brief progress reports outlining progress in research, clinical and career development activities will be required at six-month intervals.

4.  Scholars and mentors are required to participate in virtual laboratory meetings quarterly.

5.  The Francis S. Collins Scholars Program in Neurofibromatosis Clinical and Translational Research is administered by the Neurofibromatosis Therapeutic Acceleration Program (NTAP) of Johns Hopkins University, Department of Neurology.  All applications will undergo peer review orchestrated by NTAP with the goal of appointing two scholars each year. This is not an NIH sponsored award and NIH is not involved in the selection process or administration of the program.

6.  All applicants will receive reviewer comments.  Applicants who are not selected are encouraged to re-apply the following year (assuming that they still fulfill eligibility requirements).

Addendum 1: Checklist:

Cover sheet with personal information (page 1) Professional history (page 2)
Personal introduction and mission statement video Career development plan (3 page maximum) Research project description (10 page maximum) NIH formatted biosketches
Mentorship plan (3 page maximum)

Signature pages (to be uploaded to the application)
o	Applicant
o	Authorized official for the University

Three letters of support to be submitted via email to  info@n-tap.org from your:
o	Lead mentor
o	Another member of your mentorship team
o	Department chairperson
o	Other at your discretion

Please make sure you have completed all sections of the entire application and uploaded them to  info@n-tap.org with the subject line identified as: “Last,First.FSC.application-documents” and “Last,First.FSC.application-video”. The due date and time is February 10, 2015 11:59 p.m. EST.  Late and incomplete applications will not be accepted.

Addendum 2: Signature pages a.	Applicant

I certify that the statements herein are true and complete to the best of my knowledge and that I will comply with all applicable NTAP terms and conditions governing my potential appointment. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties.

Applicant’s signature:  	

Date:  	

b.	Authorized official for the University

This individual is qualified for this program and will receive immediate priority for clinic coverage (if applicable), all requirements for protected time, and all financial needs according to the RFA.

As an authorized official of  	, I agree to grant this individual the required 100% protected time and agree that the university will cover the individual’s salary, benefits, and research support as provided through the Program from July 1, 2015 to June 30, 2017, if the individual is named a Collins Scholar.

Signature of university authorized official:  	

Date  	

Title: