2025 Diversity Supplement Trainee Form - Institute for Translational Immunology

UW 2025 Diversity Supplement Matchmaking Event (trainee)

Thank you for your interest in the 2025 Matchmaking Event! Please complete the form below to register for the event. You must complete this form, including attaching a resume/CV with contact information for 1-3 references. If you have questions please email itipb@uw.edu

Name(Required)

First Last

Email(Required)

Undergraduate Major(Required)

Select your current education stage:(Required)

Undergraduate Graduation/Expected Graduation Date(Required)

Are you eligible for the NIH Diversity Supplement?(Required)

Trainees are eligible for a diversity supplement if they are U.S. citizens or permanent residents and meet at least one of the following criteria:

Identify as belonging to a race or ethnicity that is underrepresented at UW. Definition here.
Individuals with disabilities, defined as those with a physical or mental impairment that substantially limits one or more major life activities, as described in the Americans with Disabilities Act of 1990

Individuals from economically or educationally disadvantaged backgrounds. To qualify for disadvantaged status you must meet at least 2 of the following criteria:
- Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act
- Were or currently are in the foster care system, as defined by the Administration for Children and Families
- Were eligible for the Federal Free and Reduced Lunch Program for two or more years
- Have/had no parents or legal guardians who completed a bachelor’s degree
- Were or currently are eligible for Federal Pell grants
- Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child
- Grew up in one of the following areas (only one of the following two possibilities can be used as a criterion for the disadvantaged background definition):
  - A U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer
  - A Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas

NIH guidelines state that trainees supported through diversity supplements must be U.S. citizens or permanent residents. Are you eligible under this guideline?(Required)

Please describe how participation in a NIH-diversity supplement will benefit your educational and career goals(Required)

For more information on what a diversity supplement is click here

Which research categories are you interested in? Check all that apply.(Required)

Immunology research

Microbiology research

Neurobiology/Biophysics research

Molecular & Cell Biology research

Clinical/Translational research

Cancer research

Other research

Please describe your research interests.(Required)

Please select any prior research skills or experience.(Required)

Quantitative analytical skills/experience

Qualitative analytical skills/experience

Experience working with human subjects or animals

Other

None

Please describe in more detail any prior research-related experience that required data collection and analysis. Please include the dates and duration of each experience.

If you do not have any prior research-related experience you can leave this blank.

Please upload your CV or resume using .pdf format.(Required)

Max. file size: 50 MB.

Please upload contact information (name, title, and email address) for 1-3 references using .pdf format. References might include research mentors, supervisors, advisors, community leaders, or professors. Pick references that can speak to your character and skills.(Required)

Max. file size: 50 MB.

The following questions are optional. Answers to these questions will help us identify funding opportunities for which you may be eligible.

What is your gender identity?

Do you identify as transgender?

Yes

Uncertain

What is your sexual orientation?

Do you identify with any of the following racial or ethnic groups? Select all that apply.

Asian (other than Filipino, Hmong, or Vietnamese)

Black

Filipino, Hmong, or Vietnamese

Hispanic/Latinx

Native American/Alaskan Native

Native Hawaiian/Pacific Islander

White

Other

Are you from an economically or educationally disadvantaged background?

Economically or Educationally Disadvantaged Background NIH Definition:

An individual is considered to be from a disadvantaged background if he or she meets two or more of the following criteria:

Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act
Were or currently are in the foster care system, as defined by the Administration for Children and Families
Were eligible for the Federal Free and Reduced Lunch Program for two or more years
Have/had no parents or legal guardians who completed a bachelor’s degree
Were or currently are eligible for Federal Pell grants
Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child
Grew up in one of the following areas (only one of the following two possibilities can be used as a criterion for the disadvantaged background definition):
- A U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer
- A Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas

Are you living with a disability?

Yes

Do you belong to the first generation in your family to be born and/or raised in the United States?

Yes

Do you belong to the first generation in your family to attend college?

Yes

Unsure

How did you hear about the Matchmaking Event?