| Attachment 15 - eRA Commons Person Profile Data | |||||
| Currently Collected on OMB Cleared Forms | |||||
| OMB Clearance # 0925-0001 | |||||
| Field Name | Req Opt |
Type of Field | LOV or Notes | ||
| Name and ID | |||||
| Name Prefix | O | Text | |||
| First Name | R | Text | |||
| Middle Name or Initial | O | Text | |||
| Last Name | R | Text | |||
| Name Suffix | O | Text | |||
| eRA Email | R | Text | |||
| ORCID ID | R | Text | Will be a data feed from another system | ||
| Prior Name Prefix | O | Text | |||
| Prior First Name | O | Text | will be required if a prior name is to be added | ||
| Prior Middle Name or Initial | O | Text | User will be allowed to enter as many 'prior names' as they would like | ||
| Prior Last Name | O | Text | will be required if a prior name is to be added | ||
| Prior Name Suffix | O | Text | |||
| IDENTIFICATION | |||||
| DOB (Include DNWTP option) |
R | Date | DNWTP check provided | ||
| SSN (full or last 4) | O | Text | |||
| CITIZENSHIP STATUS | |||||
| Citizenship Country | R | LOV | Country List | ||
| Status in the United States | R | Radio Buttons | US Citizen or Non-citizen National Permanent Resident of US Non-U.S. Citizen w/a temporary U.S. Visa Non-U.S. Citzen--Not Residing in the U.S. |
||
| DEMOGRAPHICS | |||||
| Gender | R | Radio Buttons | Female Male DNWTP |
||
| Ethnicity and Race | |||||
| Ethnicity | R | Radio Buttons | Hispanic/Latino Non-Hispanic DNWTP |
||
| Race | R | Checkboxes | American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White DNWTP |
||
| Disability | |||||
| Do you have? | R | Y/N | |||
| Type of Disability (Check all that apply) | R | Checkboxes | Vision Hearing Mobility/Orthopedic Other DNWTP |
||
| Disadvantaged Background? | R | Radio Buttons | No Yes DNWTP Not Applicable to me |
Moved from "Training and Career Development Specific Data" | |
| TRAINING AND CAREER DEVELOPMENT SPECIFIC DATA | |||||
| Non-Deliquency on US Federal Debt? | R | Radio Buttons | No Yes |
||
| Text Entry field if Yes | Text | ||||
Yes DNWTP Not Applicable to me (not an undergraduate) |
|||||
| EMPLOYMENT | |||||
| Add a New Job | |||||
| Employer: Select one: | R | ||||
| I work in a company or institution outside NIH | Radio Button | When selected an LOV of organizations registered in the eRA Commons is available to select from | |||
| I work inside NIH | Radio Button | When selected, a LOV of NIH ICs is available | |||
| Start Date | R | Date | |||
| End Date | O | Date | |||
| Job Title | O | Text | |||
| About This Job | |||||
| Primary Employment? | R | Checkbox | |||
| R | Radio Button | Full-Time Part-Time |
|||
| This is a job working directly for the federal government. | R | Radio Button | Yes No |
||
| This is a faculty teaching position. | O | Checkbox | If Checked, then the following Academic Rank LOV is used | ||
| Academic Rank | O | LOV | Assistant Professor Associate Professor Instructor Other Professor |
||
| This is an academic administrative position. | O | Checkbox | If Checked, then the following Position LOV is used | ||
| Position | O | LOV | Assistant or Associate Dean Chairperson of Dept (or Director) Dean Other President Vice President |
||
| Addresss & Contact Information | |||||
| R | Text | ||||
| Phone | R | Text | |||
| Street Address Line 1 | R | Text | |||
| Street Address Line 2 | O | Text | |||
| City | R | Text | |||
| State | R | LOV | State List | ||
| ZipCode | R | Text | |||
| Country | R | LOV | Country List | ||
| Reviewer Information | |||||
| What address should NIH use to contact you for reviews? | Radio Button | Options: Use my work address Use my home address |
|||
| Provide a different address If checked | |||||
| Different Address | |||||
| Street Address | R | Text | |||
| City | R | Text | |||
| State | R | LOV | |||
| ZipCode | R | Text | |||
| Country | R | LOV | Country List | ||
| Home Address | |||||
| Street Address | R | Text | |||
| City | R | Text | |||
| State | R | LOV | State List | ||
| ZipCode | R | Text | |||
| Country | R | LOV | Country List | ||
| Eligibility for Continuous Submission | LOV | LOV updated annually. Current values are: Eligibility Period: 08/16/2012 – 09/30/2013 Eligibility Period: 08/16/2013 – 09/30/2014 Eligibility Period: 08/16/2014 – 09/30/2015 |
|||
| TRAINEE PERMANENT ADDRESS | |||||
| Street Address | R | Text | |||
| City | R | Text | |||
| State | R | LOV | State List | ||
| ZipCode | R | Text | |||
| Country | R | LOV | Country List | ||
| R | Text | ||||
| Phone | R | Text | |||
| EDUCATION | |||||
| Degrees | |||||
| Degree Name | R | LOV | See separate Tab for LOV | ||
| Degree Text (for Other) | O | Text | |||
| Status: | Radio Buttons | ||||
| Degree Completed | R | Radio Buttons | w/Corresponding Date Field | ||
| In Progress, expected | Radio Buttons | w/Corresponding Date Field | |||
| Length of Program (# of Yrs) | O | LOV | 1 - 9 Years | ||
| Institution | R | Text | |||
| Location (if not in US, indicate city & country) | O | Text | |||
| Is this your Terminal Research Degree? | O | Checkbox | |||
| Area of Study-Primary | O | Text | |||
| Area of Study-Secondary | O | Text | |||
| Area of Residency |
O | Text | |||
| Residency Date Completed or Expected |
R | Date | |||
| System Generated Fields | |||||
| Fields used to aid in NI/ESI efforts. All are system-generated but part of the Person Profile | |||||
| ESI Eligibility | Yes/No | ||||
| End of Eligibility Date | Date | ||||
| New Investigator Eligibility | Yes/No | ||||
| Appeal Date | Date | ||||
| Appeal Outcome | Text | ||||
| Standard NI/ESI Eligibility is system calculated. However an exception policy has been implemented. These exceptions are handled via an appeal process. | |||||
| Reference Ltrs | |||||
| Referee First Name | R | ||||
| Referee Last Name | R | ||||
| Referee MI Name | O | ||||
| Referee eMail | R | ||||
| Referree Institution/Affliation | R | ||||
| Referree Department | R | ||||
| PI Commons User ID | R | ||||
| PI Last Name | R | ||||
| FOA Number | R | ||||
| Reference Letter Confirmation # (if re-submitting) | O | ||||
| Degrees LOV in Person Profile | |
| AB | BACHELOR OF ARTS |
| BA | BACHELOR OF ARTS |
| BOTH | OTHER BACCALAUREATE |
| BS | BACHELOR OF SCIENCE |
| BSN | BACHELOR OF SCIENCE IN NURSING |
| DC | DOCTOR OF CHIROPRACTIC |
| DDOT | OTHER DOCTOR OF MEDICAL DENTISTRY |
| DDS | DOCTOR OF DENTAL SURGERY |
| DMD | DOCTOR OF MEDICAL DENTISTRY |
| DNSC | DOCTOR OF NURSING SCIENCE |
| DO | DOCTOR OF OSTEOPATHY |
| DOTH | OTHER DOCTORATE |
| DPH | DOCTOR OF PUBLIC HEALTH |
| DPM | DOCTOR OF PODIATRIC MEDICINE |
| DRPH | DOCTOR OF PUBLIC HEALTH |
| DSC | DOCTOR OF SCIENCE |
| DSW | DOCTOR OF SOCIAL WORK |
| DVM | DOCTOR OF VETERINARY MEDICINE |
| EDD | DOCTOR OF EDUCATION |
| ENGD | FOREIGN - DOCTOR OF ENGINEERING |
| FAAN | FELLOW OF THE AMERICAN ACADEMY OF NURSING |
| JD | DOCTOR OF JURIS PRUDENCE |
| MA | MASTER OF ARTS |
| MB | FOREIGN - BACHELOR OF MEDICINE |
| MBA | MASTER OF BUSINESS ADMINISTRATION |
| MBBS | FOREIGN - BACHELOR OF MEDICINE AND SURGERY |
| MD | DOCTOR OF MEDICINE |
| MDOT | OTHER DOCTOR OF MEDICINE |
| MLS | MASTER OF LIBRARY SCIENCE |
| MOTH | OTHER MASTERS |
| MPA | MASTER OF PUBLIC ADMINISTRATION |
| MPH | MASTER OF PUBLIC HEALTH |
| MS | MASTER OF SCIENCE |
| MSN | MASTER OF SCIENCE IN NURSING |
| ND | DOCTOR OF NATUROPATHY |
| OD | DOCTOR OF OPTOMETRY |
| OTH | OTHER |
| PHD | DOCTOR OF PHILOSOPHY |
| PHMD | DOCTOR OF PHARMACY |
| PSYD | DOCTOR OF PSYCHOLOGY |
| RN | REGISTERED NURSE |
| SCD | DOCTOR OF SCIENCE |
| VDOT | OTHER DOCTOR OF VETERINARY MEDICINE |
| VMD | DOCTOR OF VETERINARY MEDICINE |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |