Applying to the Program

Please find the dates for our upcoming term here.

These are the instructions for new applicants. If you have been a part of the program before, you are now a returner -please follow here.

For a complete list of the necessary steps, please download our checklist. We ONLY accept online applications -no paper copies. Therefore please submit all of the following documents as PDF files titled: “LastName_FirstName_FormName.pdf”

  1. Acquaint yourself with the program and its commitment.
  2. Please fill out the Academic Associate Application. You will also need to attach:

    • A copy of a government ID (driver’s license, passport, etc).
    • Your most recent resume.
  3. After reading the Volunteer Handbook, please take the Volunteer Exam.
  4. Obtain two (2) letters of recommendation.

  5. Complete the Health Assessment Form.

  6. Complete your CITI Program Conflicts of Interest and IRB Members-Basic/Refresher Certification. Click here to be directed to the CITI Program website. To create an account, press the “Register” button in the blue box on the right-hand side of the CITI Program homepage.

    • Step 1, “Select an Institution”: Select ‘St. Luke’s – Roosevelt Hospital Center’ as your participating institution.
    • Step 5, “Are you interested in the option of receiving Continuing Education Unit (CEU) credit for completed CITI Program courses?”; Select ‘No’.
    • Step 6: For “Institutional email address”, use your personal or school email address. For “Department”, write in ‘Emergency Department’. For “Role in Research”, select ‘Research Assistant’.
    • Step 7: Please complete both of the required courses. On the bottom of the page, click on the check boxes next to ‘Human Subjects Research (REQUIRED)’ and ‘Financial Conflicts of Interest (FCOI) (REQUIRED)’ and then press next.
      • On the next page, ‘*Do you need to take a basic or refresher course?’ please select ‘Basic’ and press next.
      • On the next page, ‘*Please choose an appropriate BASIC course based on your research needs.’ please select ‘Investigators/Research Staff’ and press next.
    • Once you finalize your registration, you may begin each course by selecting it from the ‘Main Menu’ page. You will need to save the certificate (example here) as a PDF to include with your application

  7. Please fill out the EmSTAT Confidentiality Form.
  8. Please fill out the HIPAA Document.
  9. Please fill out the Shift Selection Form.

Have Questions? Take a look at our FAQs.

If you have a question that is not answered here or in our FAQs, please contact the Academic Associate Chiefs.


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