Form NIH-2666 "Request for Summer Intramural Research Training Award (Summer Irta)"

Form NIH-2666 or the "Request For Summer Intramural Research Training Award (summer Irta)" is a form issued by the U.S. Department of Health and Human Services - National Institutes of Health.

The form was last revised in January 1, 2013 and is available for digital filing. Download an up-to-date fillable Form NIH-2666 in PDF-format down below or look it up on the U.S. Department of Health and Human Services - National Institutes of Health Forms website.

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Download Form NIH-2666 "Request for Summer Intramural Research Training Award (Summer Irta)"

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ICD LIST NO.
Request for
Summer Intramural Research Training Award
FELLOWSHIP AWARD NO.
(Summer IRTA)
Complete this form and attach the following:
COMMON ACCOUNTING NO. (CAN)
Curriculum Vitae.
Bibliography (if applicable)
INSTITUTE AND LAB/BRANCH
Applicant's statement of academic plans and research interest
INSTRUCTIONS
Two letters of reference
Letter from the school verifying student status
PROPOSED NIH LOCATION (BG/RM) AND
Information on honors, achievements, hobbies, and outside interests
PHONE NO.
Official copies of high school, undergraduate, graduate, or medical
school transcripts
NAME (Last, first, middle)
DATE OF BIRTH
CITIZENSHIP
Permanent
U.S.
Resident
STUDENT'S CURRENT ENROLLMENT
Enrolled
Full Time
LEVEL IN SCHOOL
NAME OF SCHOOL
DISCIPLINE/FIELD
Enrolled
At Least
Part Time
PREVIOUS EDUCATION (Complete as applicable)
DISCIPLINE/FIELD
DATE OF DEGREE
DEGREE
NAME OF SCHOOL
CANDIDATE
MAILING ADDRESS
STIPEND
PROPOSED STARTING
PROPOSED ENDING
DATE
DATE
Describe in detail research experience to be obtained (Continue on plain paper, if necessary.)
PLANS
NAME
TITLE AND ORGANIZATION
REQUEST
INITIATED
SIGNATURE
DATE
BG/RM
PHONE NO.
BY
LABORATORY CHIEF DATE
ICD PERSONNEL OFFICER
DATE
SCIENTIFIC DIRECTOR
DATE
APPROVAL
SIGNATURES
ICD OBLIGATING OFFICIAL (Signature and title)
DATE
This form may be reproduced locally.
NIH 2666 (01/13)
ICD LIST NO.
Request for
Summer Intramural Research Training Award
FELLOWSHIP AWARD NO.
(Summer IRTA)
Complete this form and attach the following:
COMMON ACCOUNTING NO. (CAN)
Curriculum Vitae.
Bibliography (if applicable)
INSTITUTE AND LAB/BRANCH
Applicant's statement of academic plans and research interest
INSTRUCTIONS
Two letters of reference
Letter from the school verifying student status
PROPOSED NIH LOCATION (BG/RM) AND
Information on honors, achievements, hobbies, and outside interests
PHONE NO.
Official copies of high school, undergraduate, graduate, or medical
school transcripts
NAME (Last, first, middle)
DATE OF BIRTH
CITIZENSHIP
Permanent
U.S.
Resident
STUDENT'S CURRENT ENROLLMENT
Enrolled
Full Time
LEVEL IN SCHOOL
NAME OF SCHOOL
DISCIPLINE/FIELD
Enrolled
At Least
Part Time
PREVIOUS EDUCATION (Complete as applicable)
DISCIPLINE/FIELD
DATE OF DEGREE
DEGREE
NAME OF SCHOOL
CANDIDATE
MAILING ADDRESS
STIPEND
PROPOSED STARTING
PROPOSED ENDING
DATE
DATE
Describe in detail research experience to be obtained (Continue on plain paper, if necessary.)
PLANS
NAME
TITLE AND ORGANIZATION
REQUEST
INITIATED
SIGNATURE
DATE
BG/RM
PHONE NO.
BY
LABORATORY CHIEF DATE
ICD PERSONNEL OFFICER
DATE
SCIENTIFIC DIRECTOR
DATE
APPROVAL
SIGNATURES
ICD OBLIGATING OFFICIAL (Signature and title)
DATE
This form may be reproduced locally.
NIH 2666 (01/13)
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