Registration Form for Ethics Experts

Page 1

1.1. Name: Required

2.2. Email: Required

Please enter a valid email address.

3.3. Highest degree of qualification: Required

BA

Masters

Terminal Degree (I.e PhD, MD, JD, etc.)

4.4. Affiliation: ( I.e University of Oxford, Hospital, NGO ) Required

5.5. Position within university: Required

Faculty

Postdoc

Postgraduate student

Independent scholar

6.6. Area of expertise in ethics: ( I.e research ethics during public health emergencies) Required

7.7. Geographic area of expertise in ethics: Required

African Region

Region of the Americas

South-East Asia Region

European Region

Eastern Mediterranean Region

Western Pacific Region

8.8. Are you available to engage in ethics-related activities?

Yes

No

a.8.a. Indicate prefered activity: (I.e Provide advice; Write blogposts; Offer webinars)