Qualtrics Survey | Qualtrics Experience Management

Please read the questions carefully and answer them thoroughly.
You are currently completing the application for OBSERVATIONAL STUDIES AND DATA REGISTRIES to occur from April 7th-9th, 2025. This application is due on January 17th, 2025.

Full Name

Institution

Department or Divison

Current Position

Address

Phone Number

E-mail Address

Please upload an updated curriculum vitae (CV)

Please upload a letter of recommendation from a current mentor or supervisor.

Mentor or supervisor's name

Mentor or supervisor's e-mail

STATEMENT OF INTEREST
Please describe your areas of academic interest, career goals, and what you hope to achieve by participating in this workshop (up to 250 words).

This workshop is interactive. Participants will be asked to develop a protocol for an observational study. Briefly describe (up to 250 words) what topic might be suitable for you to develop a protocol, including the following:
1) Rationale
2) Research question
3) Preliminary proposed methods

If you don’t have a current research topic, you can think of one that would be suitable for your area of interest. This will assist us in preparing for the workshop.

STATEMENT OF COMMITMENT: I commit to attend all three days of the workshop and to participate in interactive activities during the sessions as required, including development of a protocol.

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