2.0TEST UW-Madison Biotechnology Training Program (BTP) Trainer Application PAGE

UW-Madison Biotechnology Training Program (BTP) Mentor Application Form

Questions about this form? Contact Cheri Stephens at cheri.stephens@wisc.edu.
  • Please note * fields are required.
  • List any other departments or graduate programs that you have an affiliate or joint faculty appointment.
  • As part of this application, please also include a copy of your NIH-style biosketch (using the new format; instructions, template and sample available at https://grants.nih.gov/grants/forms/biosketch.htm). Please provide a personal statement (Section A) that describes the appropriateness of your research background for the BTP training program, and your commitment to the following: • Training, mentoring, and promoting inclusive and supportive research environments; • Maintaining a record of, and training in rigorous and unbiased experimental design, methodology, analysis, interpretation and reporting of results; • Supporting trainees to transition into careers in the biomedical research workforce that are consistent with the trainees' skills, interests, and values; and • Fulfilling the need of the trainees to obtain their Ph.D. degrees in a timely fashion File must be less than 24MB. Allowed file types: pdf doc docx.
    Accepted file types: pdf, doc, docx.
  • As part of this application, please provide a NIH-style Other Support document (instructions and sample available at https://grants.nih.gov/grants/forms/othersupport.htm) File must be less than 24MB. Allowed file types: pdf doc docx.
    Accepted file types: pdf, doc, docx.
  • As part of this application, please include a list of all non-sponsored funding to include start-up, retention and foundation monies.
    Funding Source (VCRGE, Dept., Foundation, etc.)Type of funding (Professorship, Retention, Start-up, etc.)Initial Award AmountDates for allowable spendingUW Project number (i.e. 135-ABC1234) 
  • Briefly summarize the goals and focus of your research program. This information will be added to the BTP website.
  • List all graduate-level (over 300) courses you teach. Please list the Course name, Department / Course Number, Dates of Course, Number of Lectures (i.e. MWF, once a week).
    Course NameDepartment / Course NumberDates of CourseNumber of Lectures (i.e. MWF, once a week) 
  • Please identify no more than three (3) T32 programs (including BTP) where you intend to participate as a faculty mentor.
  • BTP mentors are required to participate in the Training Program. Please indicate which of the following activities you will participate in.
  • If you have any questions, please contact Cheri Stephens at cheri.stephens@wisc.edu.