U.S. Department of Health and Human Services
National Institutes of Health and
Agency for Healthcare Research and Quality
Ruth L. Kirschstein National Research Service Award
Individual Fellowship Application
PHS 416-1 (Revised 10/2005)
See the 12/9/2005 NIH Guide Notice for important changes to this version.
All notable changes made to PHS 416-1 are listed at the bottom of this page (Updated 4/14/2008).
Downloadable Instructions and Form Files
Some of the MS Word and PDF files are large and may take a few minutes to download.
| PHS 416-1 Instructions | ||
|---|---|---|
| Instructions | MS Word |
PHS 416-1 Fillable Forms
The links below allow for downloading of individual and combined form files in MS Word and PDF formats. Please see the Adobe Acrobat or PDF Forms section of the "Help Downloading Files" page for information on using the fillable PDF forms.
| Fillable Individual PHS 416-1 Forms | ||
|---|---|---|
| Form Page 1: Face Page | MS Word | |
| Form Page 2 Sponsor/Co-Sponsor Contact Information and Description | MS Word | |
| Form Page 3: Goals, Activities Planned, Training Sites, Human Embryonic Stem Cells | MS Word | |
| Form Page 4: Table of Contents | MS Word | |
| Applicant/Fellow Biographical Sketch Format Page | MS Word | not provided |
| Applicant/Fellow Biographical Sketch SAMPLE | MS Word | not provided |
| Form Page 5: Previous Research Experience | MS Word | |
| Continuation Page (Blank page used for Research Training Plan and Sponsor's Information) | MS Word | |
| Sponsor/Co-Sponsor Biographical Sketch Format Page | MS Word | not provided |
| Sponsor/Co-Sponsor Biographical Sketch SAMPLE | MS Word | not provided |
| Checklist Form Page | MS Word | |
| Personal Data Form Page | MS Word | |
| References | MS Word | |
| Targeted/Planned Enrollment Table Format Page | MS Word | |
| Inclusion Enrollment Report Format Page | MS Word | |
| Mailing Address and Labels | MS Word | |
| Combined PHS 416-1 Forms File
Does NOT include the Applicant/Fellow or the Sponsor/Co-Sponsor Biographical Sketch pages or Continuation page. See Individual Form file links above. |
Combined PHS 416-1 Form Files (MS Word) |
Combined PHS 416-1 Form Files (PDF) |
For Questions Related to:
- Application Procedures/Forms Submission: contact GrantsInfo at grantsinfo@nih.gov or 301-435-0714.
Note: Other software packages for completing these applications may be available from other sources; however, it is essential that the type size and format specifications are met. Otherwise, application processing may be delayed, or the application may be returned to the applicant without review.
Disclaimer: Reference to these software packages neither constitutes nor should be inferred to be an endorsement or recommendation of any product, service, or enterprise by the National Institutes of Health, any other agency of the United States Government, or any employee of the United States Government. No warranties are stated or implied.
Notable Changes Made to PHS 416-1
- Revised NIH Public Access Policy implemented. See the 01/11/2008 NIH Guide Notice for additional information (4/14/08).
- Application Submission and Review Dates have been updated (3/1/07).
- Revisions have been made to: 1) Require the ERA Commons User Name; 2) clarify the requirements for Item 27. Doctoral Dissertation and Other Research Experience; 3) implement the new tuition reimbursement policy; and, 4) implement the new policy re: publications in appendix material. See NIH Guide Notice NOT-OD-07-002 for more details (10/5/2006).
- Revisions have been made in Part III to update contact information for The Office of Research Integrity and the Office of Human Research Protections (1/26/06).
- New PHS 416-1 (Rev. 10/05) instructions and forms posted 12/09/2005. See the 12/9/2005 NIH Guide Notice for important details regarding changes made to this version.
Go to NIH Forms and Applications Page