The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

Create Application Record

Hello Applicant,

Please complete the survey below. This form should only be completed by the applicant (PI) and not a mentor or administrator.

Please only create one application record per program. Multiple records will also delay the processing of your application.

Upon completion, you will be emailed a unique link to begin your MCHRI application.

For additional questions, please contact mchri_admin@stanford.edu or 650-724-0279.

Thank you. MCHRI Administration

SUNET ID

Applicant Name:

Applicant First Name:

Applicant Last Name:

Email Address

Department (SUnet lookup)

Org ID (SUnet lookup)

Program:

* must provide value

Applicant Title:

Mentor SUNet: please enter the SUNet ID of your mentor

* must provide value

(HIDDEN) Mentor Name

(HIDDEN) Mentor First Name

Mentor email

(HIDDEN) Mentor alternate SUNet

Do you have a primary mentor?

* must provide value

Yes

reset

Mentor SUNet: please enter the SUNet ID of your mentor

* must provide value

(HIDDEN) Mentor Name

(HIDDEN) Mentor First Name

Mentor email

(HIDDEN) Mentor alternate SUNet

Withdrawn

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.