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Application for Emory University’s T32 Pre-doctoral Training Program

Training in Advanced Data Analytics for Behavioral and Social Sciences Research (TADA)

|Last Name |First Name |Middle Name |

|Permanent Address - Street |City |State |Zip |

|Country |Telephone: (Cellular) |Telephone: (Home) |Email Address: |

| |( ) |( ) | |

|U.S. Citizen: |IF NOT A U.S. CITIZEN: | |

|□ Yes □ No |Permanent U.S. Resident: □ Yes|Other Citizenship Status (please specify): ___________________________ |

| |□ No | |

|Equal Opportunity/Affirmative Action |

|We are required by NIH to collect the following information for reporting purposes. Emory University is committed to a policy of equal opportunity and |

|affirmative action in the appointment process. We welcome and encourage applications from underrepresented minorities, women, and persons with disabilities. |

|Gender: □ Man □ Woman □ Transgender □ Other |

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|Race (check all that apply) |

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|□ American Indian □ Native Hawaiian or Pacific Islander □ Asian □ Black/African-American |

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|□ White □ Other □ Intentionally Withheld |

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|Ethnicity |

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|□ Hispanic or Latinx □ Not-Hispanic or Latinx □ Intentionally Withheld |

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|Doctoral Program Information: |

|Enrolled in which doctoral program: |

|□ Behavioral, Social, Health Education Sciences (BSHES) □ Health Policy & Management (HPM) |

|□ Sociology (Health Track) □ Clinical Psychology |

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|When did you take your comprehensive exam or plan to take your exam? ___/___/_____ |

|mm/ dd / yyyy |

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|If you’ve taken the exam, what were the results? □ Pass □ Provisional Pass □ Fail   |

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|Proposed Dissertation Title: |

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|Dissertation Advisor: |

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|Additional Information: |

|How did you hear about the TADA Training Program? |

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|Faculty member(s) you would consider working with and your shared interests: Please refer to TADA tab on the Spark website for a full roster of TADA faculty |

|(sph.emory.edu/spark) |

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|What kinds of big data are you interested in learning how to analyze? (Check all the apply) |

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|□ Geospatial data □ Gene-environment interplays □ Social networks data □ Large administrative databases (e.g., EMR) |

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|□ Machine learning for social media and other Internet data |

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|Other (please specify): ___________________________________________________________________________________________ |

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|What previous coursework and/or training have you taken in analyzing big data? |

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|Geospatial data: ________________________________________________________________________________________________ |

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|Gene-environment interplays: _____________________________________________________________________________________ |

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|Social networks data: ___________________________________________________________________________________________ |

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|Large administrative databases (e.g., EMR): _________________________________________________________________________ |

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|Machine learning for social media and other Internet data: ______________________________________________________________ |

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|Other (please specify): __________________________________________________________________________________________ |

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CERTIFICATE STATEMENT AND SIGNATURE

I certify that the information submitted in this application and associated materials is complete and correct to the best of my knowledge.

______________________________________________ ______________________________________

Signature Date

PLEASE SUBMIT THE FOLLOWING:

(Applications to the TADA Program are accepted on a rolling basis)

1. One-page essay on your research interests and planned dissertation on applying advanced data analytics to SUD-related health problems.

2. Log of SUD-related research or programmatic work activities that you’ve participated in since inception of your PhD program. Please include courses taken, papers written on SUD-related topics for courses, seminars attended, formal Graduate Research Assistant positions held, and published papers

3. Two letters of recommendation from faculty (1 from advisor)

4. Copy of official transcript

5. Curriculum Vitae

Please send documents electronically to:

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Laura Donnelly

TADA Program Manager

ldonnel@emory.edu

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