APPLICATION

I have read and agree to the Privacy Policy*

Last name*

First name*

Email address*

Job Title* (Assistant Professor, Associate professor, etc.)

Principal Investigator since*

PhD Date*

External Funds for the next 24 months in Euro*

Current Department*

Current Institute*

Current Institute Address*

Cell phone (including country code)*

How did you hear of the Award?*

Title of Project*
Host Institute: Please remind the Host Institute's department head to write on institute letterhead, sign and scan the letter and include the name of the applicant and the institute in the pdf title (eg MillerL from RossiP). This letter should be emailed directly to armeniseharvardfdn@hms.harvard.edu (cc’d to the candidate) by the May 31 deadline

Host Department*

Host Institute*

Host Institute Address*

Head of Department*

Dept. Head Phone*

Dept. Head Email*

Upload your attachments: Please ensure that your name is included in the title of each document (e.g. MillerL CV.pdf, MillerL Publications.pdf, etc.) and the document title, date, and page number appear in the header or footer of each page in each separate document.
Acceptable file types: PDF.
Maximum file size: 3mb.

Curriculum Vitae (including list of publications)*

Proof of Eligibility*

Synopsis*

Scientific Proposal*

Budget*

Describe any other support you may have in support of your Scientific Proposal

Have you already applied before to the AHA MCA?*
YesNo

If yes, when have you applied?

WARNING

The application period is March 1 – May 31, 2023