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U.S. Department of Health and Human Services

OMB Approval: OMB No. 0910-0833, Expiration Date: 06/30/2020; See OMB statement below
FDA Advisory Committee Membership Application

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FDA Advisory Committee Membership Qualifications

Nominee(s) nominated as scientific members are technically qualified experts in the field (e.g., clinical medicine, engineering, biological and physical sciences, biostatistics, and food sciences) and have experience interpreting complex data. Candidates must be able to analyze detailed scientific data and understand its public health significance.

FDA Advisory Committee Membership Types:

The FDA Advisory Committee Membership Application accepts applications for Academician/Practitioner, Consumer Representative, and Industry Representative membership types. Please see Advisory Committee Membership Type for more details regarding membership types.

Advisory Committee Membership Application Checklist

Upload the following documents in PDF format to complete application:
  1. Curriculum vitae for each nominee;
  2. Acknowledgment and Consent Form (Consent Form);
  3. A written confirmation that the nominee(s) is aware of the nomination (unless self-nominated);
  4. Letter(s) of recommendation;
  5. For Consumer Representative applications, include a cover letter that lists consumer or community organizations for which the candidate can demonstrate active participation.
NOTE: Do not include your Social Security Number on any of your application materials.
Files over 20MB cannot be uploaded into application.
The Advisory Committee Program is not responsible for technical issues unrelated to the application database that may result in a late or incomplete application.

Be sure to review:

Vacancies, Qualifications, and Experience for more details concerning vacancies on each committee and the qualifications and experience common for nominees. Vacancies are updated periodically; therefore, one or more vacancies listed may be in the nomination process or a final appointment may have been made.

Conflict of Interest. Potential candidates are asked to provide detailed information concerning such matters as financial holdings, employment, and research grants and/or contracts in order to permit evaluation of possible sources of conflict of interest.

Be sure to tell us how you heard about us (e.g., attendance at a professional meeting, an article in a publication, our website, while speaking with a friend or colleague).

I have read and understand nominee qualifications and the Advisory Committee Membership Application Checklist.
Privacy Act Statement
Privacy Act Notice: FDA will use the information you submit to determine qualifications for positions on Federal Advisory Committees, and if you are selected, FDA will publish your curriculum vitae (CV), and any subsequent updates to your CV that you provide to the FDA, on FDA’s web site, without removing or redacting any information. The full Notice required by the Privacy Act (5 USC §552a(e)) is available here.
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing Instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer PRAStaff@fda.hhs.gov
An agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.0910-0833; Expiration: 06/30/2020