Proposal Guidance Panel Interest

NCRI Proposal Guidance meeting - Panel Interest Form

Name *

First

Last

Email *

Group Role *

Please indicate your current or former role on the NCRI Research Groups

Do you/have you sat on a NCRI Group *

Yes, I do currently
Yes, but do not currently
No, I have never sat on a Group

Which Group do you currently sit on?

Which Group did you sit on?

How did you find out about this opportunity?

(e.g. Through Tenovus, e-mail from NCRI, Twitter)

Specialisms and Areas of Interest *

I am holding the time in my diary for the Proposal Guidance meeting: *

8th March - Prehabilitation Proposal Guidance meeting
28th April - Prevention & Early Diagnosis Proposal Guidance meeting

Please tick if you are available to attend. Please keep this dates free for further communication, we aim to give at least 6 weeks notice of which proposal guidance session we have allocated you to (sessions will be approximately 2-3 hours long, this will be based on the number of applications in your allocated session)

Preferences for time slots:

8th March AM
8th March PM
8th March Both AM & PM

Preferences for time slots:

28th April AM
28th April PM
28th April Both AM & PM

Confidentiality Agreement - Proposal Guidance

Panel Members must agree to all terms of the Confidentiality agreement outlined below:

I, a panel member, with regards to the proposal ideas being presented at this proposal guidance session, agree not to use the presented information for purposes other than to provide guidance to the presenter(s)/investigators *

I agree

You must agree to be accepted onto the panel

I agree to only to disclose the information shared and presented as part of the proposal guidance process with the express written permission of the presenter(s). *

I agree

You must agree to be accepted onto the panel

I agree to disclose any conflict of interest that I have with any proposals that I am asked to review. *

I agree

You must agree to be accepted onto the panel

Proposal guidance sessions will be video recorded for note taking and consistency evaluation. Only the NCRI Office will have access to these files. Please contact the NCRI (proposal.guidance@ncri.org.uk) if you would like to find out more. I agree to the proposal guidance session being recorded for office use. *

I agree