Fauci Fellowships Application

Please complete the below application in English.

Please Note: Fields with a red * are required


    Applicant Information:

    * How did you hear about the Fauci Fellowships and the NIAF?
    * First Name:
    Middle Name:
    * Last Name:
    * Gender:
    * Mailing Address:
    Mailing Address (continued):
    * City:
    * State:
    * Zip Code:
    * Primary Phone:
    * Permanent E-mail Address (non ".edu" email ONLY):

    Applications submitted with a ".edu" email address will not be considered
    *Confirm E-mail Address:
    * Date of Birth:

     

    Background Information:

    Please specify whether you are Italian or Italian American:

    * Father of Italian Descent?
    * Mother of Italian Descent?
    * Italian region(s) where your ancestors are from. (To select multiple regions, press the Cntrl key as you click the regions)

    Enter more specific cities (optional)

     

    Applicant Information:

    * Name of College/University Where You Earned Your PhD:
    * Major/Area of Study:
    * Year of Doctoral Graduation:

     

    Research Proposal:

    * Title of Proposed Research:
    * Name of the Host Institution:
    * Location of the Host Institution:
    * Name and Title of Host Mentor:

    NOTE: Your application is not complete. You must also submit PDFs of the documents outlined in the application instructions, written in English. As soon as you submit the information above, you will receive an email from info@niaf.org with a drop box link, which you will use to upload the remaining documents. Deadline to submit all application materials is May 20, 2021 at 11:59 pm EDT.