Attachment 3_RR_PersonalData_1_2-V1.2.pdf
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- Opportunity number
- HT9425-23-S-SOC1
- Issued by
-
Department of the Army Medical Command
About this file
This document contains a personal data attachment template for project directors and co-project directors to submit with research grant proposals. It requests optional demographic information including gender, race, ethnicity, disability status and citizenship to monitor diversity in federal award processes. Submission of this data is voluntary and confidential, and will not be part of the proposal review.
A related Broad Agency Announcement solicits research and development proposals under the Military Medical Research and Development federal grant program. Proposals are due by various dates for fiscal year 2023 funding from the Department of the Army Medical Command to extramurally support biomedical and human performance research. Awards will focus on improving military medicine, with values to be determined. Eligible federal grant programs and the involved agency were specified.
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Text version
OMB Number: 4040-0001 Expiration Date: 11/30/2025
RESEARCH & RELATED PERSONAL DATA
Project Director/Principal Investigator and Co-Project Director(s)/Co-Principal Investigator(s)
The Federal Government has a continuing commitment to monitor the operation of its review and award processes to identify and address any inequities based on gender, race, ethnicity, or disability of its proposed PDs/PIs and co-PDs/PIs. To gather information needed for this important task, the applicant should submit the requested information for each identified PD/PI and co-PDs/PIs with each proposal. Submission of the requested information is voluntary and is not a precondition of award. However, information not submitted will seriously undermine the statistical validity, and therefore the usefulness, of information received from others. Any individual not wishing to submit some or all the information should check the box provided for this purpose. Upon receipt of the application, this form will be separated from the application. This form will not be duplicated, and it will not be a part of the review process. Data will be confidential.
Project Director/Principal Investigator
Prefix: * First Name: Middle Name:
* Last Name: Suffix:
Gender:
Race (check all that apply):
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Do Not Wish to Provide
White
Asian
Ethnicity: Disability Status (check all that apply):
Visual
Other
Mobility/Orthopedic Impairment
None
Hearing
Do Not Wish to Provide
Citizenship:
File details come from the government source that posted it. Updated .