Application Form
The Clinical Immunology Society (CIS) and the Jeffrey Modell Foundation are pleased to announce the I-CIS Innovation Grant – Vicki Modell Award, which offers an award to an individual in the third or fourth year (at the time of the award start) of their fellowship program with a concentration or focus on primary immunodeficiency and inborn errors of immunity. The 2026 Fellowship Award will provide one individual a one-year grant in the amount of $50,000. The objective of the grant is to support the development of academic clinical immunology research careers of fellows-in-training who have demonstrated commitment to the study of primary immunodeficiency as a career path in the United States and Canada. Funding is to support the education and research endeavors of this individual. This award is made possible by a generous unrestricted grant from the Jeffrey Modell Foundation.
Applicant Contact Information
Name
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First Name
Last Name
Email
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Address
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Street Address
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Training Institution:
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Training Graduation Date (MM/DD/YYYY)
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Phone Number
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Biographical Sketch (NIH Format)
Include a full disclosure of all grants or awards currently received or pending including a statement of any overlap. Uploads must be in .pdf format.
NIH Bio Sketch
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Personal Statement
Not to exceed one page. Summarize your training to date, comment on your specific clinical and research interests, describe the percentage of time allocated for your responsibilities (including research, teaching, clinical and administrative duties). Upload must be in .pdf format.
Personal Statement
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Career Development Plans
Not to exceed one page. Describe current and future plans for overall career development including training and research goals. Include specifics about how this award will contribute to your career development. Uploads must be in .pdf format.
Career Development Plans
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Letter of Recommendation from Clinical Research or Lab Supervisor
This section should be prepared jointly by the lab director and the training program director. Describe the training environment that will support the clinical and research development of the applicant. Include details of current or upcoming projects. The letter writer must sent the LOR directly to the CIS Executive Director, Madeleine Hanan, at mhanan@clinimmsoc.org. LORs that are not received by the February 3rd deadline are considered incomplete and ineligible for consideration.
I have or will have my letter writer send the LOR directly to mhanan@clinimmsoc.org to complete my application:
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I agree
Specific Aims
Uploads must be in .pdf format.
Specific Aims
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Research Plan
Font size 11 points or larger, single space, and at least ½” margins; not to exceed three pages in NIH format: Provide documentation, if applicable, upon receipt of the funds that the proposed research was approved by the Institutional Animal Care and Use Committee (IACUC) or human subjects Institutional Review Board (IRB) of the grantee institution. Provide description of Budget and Budget Justification in NIH format. Uploads must be in .pdf format.
Project Outline
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Primary Mentor Biographical Sketch
Provide your primary mentor biographical sketch in NIH format.
Primary Mentor Biographical Sketch
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Financial Conflicts of Interest Statement(s)
For each investigator, list real or potential financial conflicts of interest with the proposed studies. Financial conflicts of interest would include direct payments from corporate entities related to the proposed studies and/or investments that would benefit the investigator or the investigator’s family as a result of the proposed studies.
Enter all real or potential conflicts of interest in the space provided. Type "None" if none.
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Institutional approvals: Agreement, if applicable, that upon receipt of the funds that the proposed research will be approved by the Institutional Animal Care and Use Committee (IACUC), human subjects Institutional Review Board (IRB), Institutional Biosafety Committee, and/or other relevant approvals to conduct the proposed research of the grantee institution.
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Not applicable
Letter of Recommendation
Upload your letter of recommendation, not to exceed two pages. Letter must be from Division Chief or equivalent and include: Details on the Institutions’ commitment to the applicant; Applicant’s qualifications for an academic career and availability of funding for applicant’s academic training expenses; Applicant’s training/career development plan (specify skills to be acquired). The letter writer must sent the LOR directly to the CIS Executive Director, Madeleine Hanan, at mhanan@clinimmsoc.org. LORs that are not received by the February 3rd deadline are considered incomplete and ineligible for consideration.
I have or will have my letter writer send the LOR directly to mhanan@clinimmsoc.org to complete my application:
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I agree
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