Center for Human Immunobiology Membership Application

Please note: All membership applications must come from Northwestern University Faculty or Trainees. All applications that are accepted for membership will have a faculty profile link visible on our member page. For any questions about membership or applications questions/requirements please contact us immunology@northwestern.edu

First Name
Last Name
Middle Name/Initial
Desired Classification

Desired Classification Faculty Member Trainee Member Staff Member
Degree
Email
Email of assistant who should be copied on email correspondences
NU NetID
Department
Division
Training lab you are associated with (if not applicable write n/a)
Title
Institution (NU, NMH, Lurie, SRAL, other)
Campus (Chicago/Evanston/Other)
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone Phone - ### - ### ####
Research Statement
Please provide a brief statement (2-3 sentences) describing your immunobiology relevant clinical and/or research activities and interests.
4-5 Keywords that indicate the area within immunology that you work on (e.g., immunometabolism, microglia cells, Regulatory T cells, etc)
ORCID iD
NIH BioSketch (upload as Word document)

Attach Files
NIH BioSketch or CV (upload as Word document preferred)

Attach Files
Active Grants/Other Support Page (upload; no signature needed)

Attach Files
Please Upload a Headshot/Photo for our website Membership Page - we will be posting all of our trainees on our website under our membership page.

Attach Files