Research Ethics Program Application

RESEARCH ETHICS PROGRAM APPLICATION FORM

  • PART I: PERSONAL INFORMATION

  • (as it appears in your passport)
  • PART II: PROFESSIONAL INFORMATION

  • PART III: EDUCATIONAL BACKGROUND

  • Please list in chronological order all educational experiences leading to an academic degree.
  • PART IV: DESCRIPTION OF PRESENT WORK AND RESEARCH EXPERIENCE

  • PART V: EXPERIENCE ETHICS AND RESEARCH ETHICS

  • Part VI: FUTURE ACTIVITIES IN RESEARCH ETHICS

  • PART VII: OTHER APPLICATION MATERIALS REQUIRED

  • WITH YOUR APPLICATION – PLEASE ATTACH THE FOLLOWING:

    1. A Curriculum Vitae (not more than five pages)
    2. Copy of your passport
    3. Please have two individuals (one of whom holds a high position in your institution (e.g., President, Dean, Vice-Dean) send letters of recommendations to: hsilverm@medicine.umaryland.edu
    4. Please send your official transcripts from prior academic institutions to: hsilverm@medicine.umaryland.edu
  • I declare that this information is completely accurate and without falsifications.
 

Verification

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