Questionnaire for Access to CTR-IN Editing Services

Questionnaire for Access to CTR-IN Editing Services for Papers, Abstracts and Presentations

UNLV-400

Planned Submission date:

Author/Investigator First Name (required)

Author/Investigator Last Name (required)

Author/Investigator University/Institution (required)

If Other Selected Enter University/Institution below

Author/Investigator Department (required)

Author/Investigator Email (required)

Author/Investigator Degree(s) (required)

Author/Investigator Academic Title (required)

Contact Phone Number (required) eg. (123) 345-6789

Is this a: ManuscriptMeeting AbstractPresentationOther
If Other Selected Please Describe below:

Name of Target Journal or Meeting: (required)

Is this work a direct outcome of a CTR-IN Award? NoYes
If Yes, complete below:
Award Year:

Award Type:

PI (Full Name):

Does this work involve any additional CTR-IN partner institutions? NoYes
If Yes, select below: