Toggle navigation Load unfinished survey Resume later Exit and clear survey Language: English - English English - English Français - French default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. CNeuromod data access form Principal Investigator (This question is mandatory) Last name First name (This question is mandatory) Academic position (This question is mandatory) Affiliation (This question is mandatory) Province, country (This question is mandatory) Institutional email Project (This question is mandatory) Project title (max 250 characters) (This question is mandatory) Project description following this structure (max 2500 characters) Background Aims Hypothesis Methods Expected results (This question is mandatory) I accept that my project be listed on the neuromod website. Yes No Project logo Please upload at most one file Upload files × Upload file Collaborators Lists of researchers associated with the project Name Affiliation Email 1 Name Affiliation Email 2 Name Affiliation Email 3 Name Affiliation Email 4 Name Affiliation Email 5 Name Affiliation Email Institutional representative An institutional representative has legal authority to sign a data transfer agreement for the institution. Here is a suggested short list of people who would be considered as institutional representative: Office of the vice chancellor for research Office of sponsored research Head of the office of innovation and partnership Vice principle for research and innovation (This question is mandatory) I attest, the institutional representative has been advised that he/she will be asked to sign the Data Transfer Agreement (DTA). Yes No (This question is mandatory) Last name / First name (This question is mandatory) Position (This question is mandatory) Address (This question is mandatory) Email Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×