JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Online Neuroscience Course Application 2022
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Emails should be from institutions (e.g.,
xxx@mit.edu
not
xxx@gmail.com
)
If you don't possess one ,please enter whatever address you have and fill the comment box at the end of the form
Applicant's Last Name
*
Your answer
Applicant's First Name
*
Your answer
Billing Address
Postal address
Your answer
Phone Number
A phone number at which you can be contacted
Your answer
Where do you work?
*
Indicate the lab, PI's name, institution, city, country...
Your answer
Fee waiver requested
Please explain briefly why you are asking for a fee waiver
Your answer
I am a Guest
Check the box only if you are a member of a partner institution (SPPIN,ICM, PSL, IBPS, Institut de Vision) or from the laboratory of a coursecurrent lecturer/instructor. It seems obvious but don't pay if you are a guest!
Yes
In case you don't have an institutional email please explain here why
Please include the email of an academic person who can vouch for you (typically a lab PI).
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
