Join the NIHAlumni Network Please complete the form below to join the Network. NIH Alumni Network Membership Application Form This is a secure site. The information provided on this form is confidential and will not be shared outside our organization. All fields on the form are required unless indicated as optional. Username Password Confirm Password First Name Middle Initial Last Name Degree (optional) E-mail Address Confirm E-mail Full Name LEAVE THIS BLANK Your NIH Career Phone (optional) Address Type Home Work Street Address Street Address Line 2 (optional) City State Alaska Alabama Arkansas American Samoa Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Northern Mariana Islands Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming ZIP Code Year began working at NIH (earliest, enter as 4-digit year) Year left NIH (most recent, enter as 4-digit year) NIH Institute/Center/Office for which you worked (can select multiple) NCI NEI NHLBI NHGRI NIA NIAAA NIAID NIAMS NIBIB NICHD NIDCD NIDCR NIDDK NIDA NIEHS NIGMS NIMH NIMHD NINDS NINR NLM CC CIT CSR FIC NCATS (includes NCRR) NCCIH (formerly NCCAM) OD Job title at the time you left NIH Job category (can select multiple) Administrator Scientist Other Employment category (can select multiple) Federal Employee Trainee/Fellow On-site Contractor Other Additional information Please provide any additional information that you would like to share about your NIH career (if your years worked were not continuous, years at different ICOs, etc.) How did you hear about the NIH Alumni Network? (optional) FNIH communications Word of mouth Other Please specify Job Category - Other (Please Specify) Employment Category - Fellow/Trainee Type Employment Category - Other (Please Specify) Log In