CECR Registration Form
     

Personal/Institutional Information
     
Full Name :               
Date Of Birth :      Gender  
 
Phone No :             Mobile
Email Address :         Fax :
Nationality :           Job Title
Work Address :        
     
Education Background
Degree :  
     
University :        Faculty
Department :        
Graduation Year :      
MSc Thesis Title :       
PhD Thesis Title :      
Research Interest :    
Keyword :                  
     
Questionnaire

1.     What are you looking for from the center?
   
   
     

2.     What type of research you are doing?
     
   
     

  3.Are you willing to collaborate with the center through one of the followings: ?

    
     
   
     

4.     Are you collaborating with any national or international partners?

    
     
   

If your answer is(Yes)please mention the followings:
     

a.     Name of partner  

   
     

b.     Address              

   
     

c.     Field of research  

   
     

5.     Are you Funded by any project?

    
   

If (Yes) please mention the following :

    
     

a.      The title and abstract of the project

   
     

b.     Team Work

    
     

c.     Funding source you will apply for

    

d.     Budget

    
     

6.     Are you planning to write a research project in  cancer research or related fields?

    
   

If(Yes) please mention the following :

    
     

a.     The title and abstract of the project

   
   
     

b.     Team Work

    
   
     

c.     Funding source you will apply for

    
   
     

d.     Budget

    
   
     

7.     What are your prior experience in cancer research , in particular technical skills?

    
     
   
     
8.  Have you registered in any patent or intellectual property  right?
     
   

If (Yes) please mention the followings:

    
     

a.     Title of the invention

    
   
     

b.     Information about the invention

    
   
     

9.     Have you published papers  in cancer research or related fields?

    
     
   
     

If (Yes)please group them :

    
     

National  journals:

    
   
     

International   journals: