1350 Broadway, 17th Floor, New York, NY 10018   |   Phone:  (212) 356-0693

 


Petition To Waive The Bachelors' Degree Requirement


 
PERSONAL DATA:  
Last Name & suffix (if any):
First & Middle Names and/or Initials:
Phone:
Address:
City
State:
Zip:
Email:
   
EDUCATIONAL BACKGROUND 
(List most recent educational experience first):
   
PROFESSIONAL DEVELOPMENT  
(List any relevant courses, workshops, or professional meetings attended in the past five years)
:
   
NAMES & AFFILIATIONS OF TWO REFERENCES WHO ARE PROVIDING LETTERS ATTESTING TO YOUR EMPLOYMENT IN RESEARCH ADMINISTRATION.  (One letter must be from a current  CRA or an institutional director of preaward or postaward research administration.)
Name:
Affiliation:
Name:
Affiliation:
   
CAREER HISTORY  (List current or most recent position first):
Organization:
From: To:
Address:
City:
State: Zip:
Phone:
Position:
Supervisor:
Brief Job Description

Organization:
From: To:
Address:
City:
State: Zip:
Phone:
Position:
Supervisor:
Brief Job Description

Organization:
From: To:
Address:
City:
State: Zip:
Phone:
Position:
Supervisor:
Brief Job Description

Organization:
From: To:
Address:
City:
State: Zip:
Phone:
Position:
Supervisor:
Brief Job Description
   
WORK EXPERIENCE SUMMARY:
I. PROJECT DEVELOPMENT AND ADMINISTRATION 
Which includes:           
A.  Collection and Dissemination of Information; B.  Proposal Development; C.  Ethics;     D.  Intellectual Property)
   
II. LEGAL REQUIREMENTS AND SPONSOR INTERFACE
Which includes:    
A.  Regulations and Statutes; B.  Compliance – Federal Sponsors and General Management Practices; C.  Federal/Sponsor Appeal Procedures)
   
III. FINANCIAL MANAGEMENT
Which includes: 
A. Budgeting/Accounting; B. Costs; C.  Sponsor Financial Reporting; D.  Audit)
   
IV. GENERAL MANAGEMENT
Summary of Work Experience: 
A.  Facility Management; B. 
Environmental Management; C.  Contracts and Purchasing; D.  Records Management; E.  Human Resource Management
   
LETTERS FROM TWO REFERENCES ATTESTING TO YOUR EMPLOYMENT IN RESEARCH ADMINISTRATION ARE REQUIRED.  (One letter must be from a current CRA or an institutional director of preaward or postaward research administration.)
Please email these letters to:
racc@ptcny.com
or mail them to:
Research Administrators Certification Council
1350 Broadway, 17th Floor
New York, NY 10018
212-356-0693

 

   I attest to the accuracy of the information provided herein

   

 

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