TMCF | Novartis Faculty Grant Submission Form
Name
First Name
Last Name
What are your preferred pronouns?
Please Select
She/Her
He/Him
They/Them
Other
Please input your institutional email address
example@example.com
What is the best email to reach you?
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your current Job Title?
Which School are you currently affiliated with?
Please Select
Alabama A&M University
Bowie State University
Charles R. Drew University
Clark Atlanta University
Delaware State University
Dillard University
Fisk University
Florida A&M University
Hampton University
Howard University
Jackson State University
LeMoyne-Owen College
Lincoln University of Pennsylvania
Meharry Medical College
Morehouse College
Morehouse School of Medicine
Morgan State University
North Carolina A&T State University
Prairie View A&M University
Southern University and A&M College
Spelman College
Tennessee State University
Texas Southern University
Tuskegee University
University of Maryland Eastern Shore
Xavier University of Louisiana
What is the title of your research proposal?
University Research contact name (Signatory if awarded the grant: this is often someone in the Office of Sponsored Research, Grants, etc)
Is there anything else you'd like to add?
Please upload your headshot
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