AMERICAN FEDERATION FOR AGING RESEARCH 55 West 39th Street, 16th floor, New York, NY 10018 (212) 703-9977 Medical Student Training in Aging Research (MSTAR) 2013 Application (Home Institution Students)

Instruction Sheet DO NOT INCLUDE this instruction sheet with your application!

Please carefully read the application guidelines on the AFAR website http://www.afar.org/research/funding/mstar/ before completing this application. Please note that this application is for students applying to conduct the program at their home institution. Your home institution must be an MSTAR Participating School (a complete list can be found here) in order for you to be eligible to participate in the MSTAR program. Application overview

The application and supporting materials are divided into three segments. A complete application consists of the following:

Person Materials Method of Submission

Applicant  Cover sheet and Email to [email protected] application form (one document)

Research Mentor  Letter detailing Email to [email protected] or hard research plan copy to the address above  NIH-style biosketch Faculty Mentor  Letter detailing Email to [email protected] or hard career mentoring copies to the address above plan and personal reference

(NOTE: If your Research Mentor is ALSO your Faculty Mentor, please see the alternate instructions on page 4.)

Please note that while the faculty materials must be submitted by the faculty members directly, it is your responsibility as the applicant to contact the Research Mentor and Faculty Mentor to request the required letters. The application is considered incomplete if any of the components is missing.

1 Application details

Materials to be submitted by the applicant The cover sheet and application must be submitted by email to [email protected], no later than January 31, 2012, at 5:00 p.m., EST. The application should be sent as a single file, not to exceed 5 MB. Files formatted solely for Macintosh will not be accepted. The file may not include any additional documents; please submit only the required materials. Late submissions or submissions sent by regular mail or fax will be NOT accepted. The application file should be named as follows: “HI Last name, First name”; for example “HI Smith, John.doc”. Upon submission, you will receive an automated confirmation of receipt from [email protected]. Please set your spam filter accordingly. Please note: You are responsible for confirming that your application has been successfully submitted. If you do not receive a receipt, you MUST contact Aimee Cegelka at [email protected] to follow up in order to confirm that your application has been received. Materials to be submitted by the applicant’s Research Mentor You must select a faculty member at your home institution to serve as a Research Mentor before submitting your application. The research mentor must submit two documents to support your application.

1) A research plan outlining how they will work with you during the research period. Suggestions for the research mentor’s letter include:

 Mentor’s relationship to the applicant and reasons for recommendation  Description of the research resources and facilities available to the applicant  Details of the plan for the student’s research activities during the project, including plans for communication and support during the research period (frequency of meetings with the applicant, etc.)

2) The Research Mentor’s NIH-style biosketch (sample format) This letter and biosketch should be emailed to AFAR ([email protected]) by the Research Mentor no later than January 31, 2013. Hard copies will also be accepted, mailed to the address above.

Materials to be submitted by the applicant’s Faculty Mentor You will also need to select a faculty member at your home institution to serve as a Faculty Mentor before submitting your application. The Faculty Mentor must be a faculty member at your medical school whose work is relevant to geriatrics or gerontology and who will act as an advisor to your ongoing geriatrics education and research activities. (You may select your Research Mentor as your Faculty Mentor as long as the Research Mentor can fulfill

2 the requirements of both roles. In this case, please see the alternate directions on page 4.) The Faculty Mentor must submit one document to support your application.

1) A mentoring plan outlining how they will work with you throughout your medical school training. Suggestions for the Faculty Mentor letter include:

 Mentor’s relationship to the applicant and reasons for recommendation

 Description of the home institution resources and facilities available to the applicant

 Applicant’s participation in didactic and clinical activities during the research period  Plans for communication and support during the research period (frequency of meetings with the applicant, etc.)  Plans to encourage and expand the applicant’s career in aging research after the research period

This letter should be emailed to AFAR ([email protected]) by the Faculty Mentor no later than January 31, 2013. Hard copies will also be accepted, mailed to the address above.

3 Alternate instructions if your Faculty Mentor is also your Research Mentor

Application overview

The application and supporting materials are divided into three segments, submitted by three different people. A complete application consists of the following:

Person Materials Method of Submission

Applicant  Cover sheet and Email to [email protected] application form

(one document)

Research/Faculty  Mentor letter detailing Email to [email protected] or Mentor career mentoring plan hard copies to the address above and research plan

 NIH-style biosketch

Faculty Reference  Letter of reference Email to [email protected] or hard copy to the address above

Please note that while the faculty materials must be submitted by the faculty members directly, it is your responsibility as the applicant to contact the Research/Faculty Mentor and Faculty Reference to request the required letters. The application is considered incomplete if any of the components is missing.

Application details

Materials to be submitted by the applicant

The cover sheet and application must be submitted by email to [email protected], no later than January 31, 2012, at 5:00 p.m., EST. The application should be sent as a single file, not to exceed 5 MB. Files formatted solely for Macintosh will not be accepted. The file may not include any additional documents; please submit only the required materials. Late submissions or submissions sent by regular mail or fax will be NOT accepted.

The application file should be named as follows: “HI Last name, First name”; for example “HI Smith, John.doc”.

4 Upon submission, you will receive an automated confirmation of receipt from [email protected]. Please set your spam filter accordingly.

Please note: You are responsible for confirming that your application has been successfully submitted. If you do not receive a receipt, you MUST contact Aimee Cegelka at [email protected] to follow up in order to confirm that your application has been received.

Materials to be submitted by the applicant’s Research/Faculty Mentor

You must select a faculty member at your home institution to serve as a Research/Faculty Mentor before submitting your application. The Research/Faculty Mentor must be a faculty member at your medical school whose work is relevant to geriatrics or gerontology and who will act as your research mentor as well. The Research/Faculty Mentor will support your application, act as primary mentor to your research activities during the program, and will act as an advisor to your ongoing geriatrics education and research activities.

The Research/Faculty Mentor must submit two documents to support your application.

1) A mentoring plan outlining how they will work with you throughout your medical school training, and a research plan outlining how they will work with you during the research period. Suggestions for the Research/Faculty Mentor letter include:

 Mentor’s relationship to the applicant and reasons for recommendation  Description of the home institution resources and facilities available to the applicant  Applicant’s participation in didactic and clinical activities during the research period  Plans for communication and support during the research period (frequency of meetings with the applicant, etc.)  Plans to encourage and expand the applicant’s career in aging research after the research period • Details of the plan for the student’s research activities during the project

2) The Research/Faculty Mentor’s NIH-style biosketch (sample format)

This letter and biosketch should be emailed to AFAR ([email protected]) by the HIFS no later than January 31, 2013. Hard copies will also be accepted, mailed to the address above.

Materials to be submitted by the applicant’s Faculty Reference

Since your Faculty Sponsor is also serving as your Research Mentor, you also must select a different faculty member who knows you well to submit a letter of reference. This person may be from your undergraduate school, current medical school, or another institution, but MUST be different from the Research/Faculty Mentor. This letter should be emailed to AFAR ([email protected]) by the faculty member no later than January 31, 2013. Hard copies will also be accepted, mailed to the address above.

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