ECITA Application

ECITA Application

Early-Career Investigator Travel Award
To review the eligibility and application criteria, please click here.
Name*

First NameLast Name
Work Email*
example@example.com
Alternate Email
example@example.com
Citizenship*
Gender*
Please indicate which of the following best represents your racial or ethnic heritage (check all that apply):*

Black/African AmericanHispanic/LatinxNative American/Alaska NativeNative Hawaiian/Pacific IslanderNon-Hispanic WhiteAsianPrefer not to RespondOther
Are you disabled?*
Defined as individuals with a physical or mental impairment that substantially limits one or more major life activities: https://www.ada.gov/pubs/adastatute08.htm
Disadvantaged or underserved background*
Defined as individuals who meet two or more criteria, including an economically disadvantaged background, first generation college graduates, and individuals from challenging social, cultural or educational backgrounds. (More info at: https://extramural-diversity.nih.gov/diversity-matters/disadvantaged-backgrounds)
I was or currently am (check all that apply):

Homeless;In the foster care system;Eligible for Federal food assistance pograms for two or more years;A first-generation college graduate;Eligible for Federal Pell grants;Raised in a designated U.S. rural area or Low-Income/Health Professional Shortage Area.None of the abovePrefer not to respond
Please describe your eligibility for this program.*
Current Employment Information
Employer Name*
Department*
Are you currently an Assistant Professor or equivalent level from government, non-profit, academic sector?

YesNoOther
Title*
Start Date for Position*
Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Education Information
Highest Degree(s) Earned*
Institution*
Highest Degree Date*
Conference Details
Please click here to view a list of conferences. Link will open in a new tab.
What conference would you like to attend?*
Specifically state how this travel award will benefit your research at present:*

0/150
Have you ever attended a Keystone Symposia conference before?*
How did you hear about the Early Career Investigator Travel Award (ECITA)?*

ColleaguePrior ECITA AwardeeKeystone Symposia WebsiteProfessional meeting or society meetingReceived email informationOther
Mentorship
Please describe your experience and commitment to mentoring and fostering diversity in the life science workforce.*

0/150
Upload Research Abstract
To be eligible for this travel award, please upload a word version of your research abstract in the link provided below. DO NOT submit your abstract using the links provided on the Keystone Symposia website.

Click here to download and print the abstract formatting guidelines.
Upload a word version of your research abstract.*

Browse Files

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Application Certification
I hereby certify that information and documentation included in this application is true and correct.*

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ECITA Application

Current Employment Information

Education Information

Conference Details

Mentorship

Upload Research Abstract

Application Certification