GLOBAL COLLABORATION WORKSHOP

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Event Timing: April 12-14, 2021
Event Address: Virtual

Email *

Name *

Organization *

Academic position *

Doctoral Student

Postdoctoral Researcher

Assistant Professor

Professor

Program Officer

Other:

If you are a student, postdoctoral fellow, or other form of trainee, please include the name and contact information of your advisor.

Did you receive a terminal degree (PhD or MD) more than 10 years ago? *

Yes

How would you describe your gender? *

Female (cisgender – gender identity corresponds to that given at birth)

Male (cisgender – gender identity corresponds to that given at birth)

Prefer to self describe

Prefer not to disclose

Are you from an under-represented minority group? *

Yes, I am from an under-represented minority group

No, I am not from an under-represented minority group

Prefer not to disclose

Planning to join the virtual "Brainhack PRIME-DRE" (April 15-16, 2021)? *

If you haven't yet decided, we would suggest selecting "Yes" at this stage.

Yes

If you have any questions, please contact us at Prime_registration@childmind.org

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