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Affiliate Membership Application

PRIMED Affiliate Membership offers the opportunity for subject matter experts not eligible for Core Membership to actively participate in and contribute to the scientific activities and mission of the PRIMED Consortium. Before applying, please see the PRIMED Affiliate Membership Policy for more detail about Affiliate Membership eligibility criteria, benefits, and responsibilities. 

Interested investigators should complete and submit the form below. Submissions are reviewed by the Consortium Executive and Steering Committees. Only one application per research group/lab is needed.

* - required

 

Are you applying from a private sector and/or for-profit entity?
(If Yes, application may require additional review by NIH program office.)
Are you offering cost-free or in-kind services to the PRIMED Consortium?
(If Yes, application may require additional review by NIH program office.)
PRIMED Working Groups in which you are applying to participate (check all that apply)
Please include: 
  • A brief description of why you would like to be considered for PRIMED Affiliate Membership
  • Specification of expertise or capabilities relevant to PRIMED 
  • Where applicable, provide information on funding available to conduct any proposed research 
  • Specification of existing or forthcoming PRIMED projects or Working Groups on which you intend to participate:, 
    • describe expertise and planned roles on the project or group
    • a brief note outlining mutual understanding of this role by the project or Working Group leader(s)
Please include:
  • Rationale for how the proposed project(s) address(es) PRIMED Consortium goals;
  • Which PRIMED groups (e.g., Working Groups, Study Sites) or investigators you are proposing to collaborate with on the new project(s) or involvement
  • Where applicable, evidence of available and proposed project funding OR a statement of willingness to participate actively without additional funding.
(names, contact email, and role within the research group, one name per line)
E.g. “Anya Smith, asmith@institution.edu, Project Manager
        José Hernandez, jhern@institution.edu, Postdoctoral Fellow” 
Please confirm
Please confirm