Canadian Translational Geroscience Network (CTGN) Membership Application Form

Thank you for your interest in joining the Canadian Translational Geroscience Network. Please complete the following form with as much detail as possible. All applications will be reviewed, and you will be contacted regarding the next steps.

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* 1. Full Name

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* 2. Primary Language

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* 3. Contact Information

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* 4. Current role/position

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* 5. Institution / Organization

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* 6. Field of expertise

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* 7. Highest degree obtained

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* 8. Please describe your primary area of research related to geroscience:

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* 9. How does your work align with the mission of the CTGN?

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* 10. Why do you want to join the CTGN?

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* 11. How can you contribute to the CTGN (e.g. expertise, collaboration, resources,...)

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* 12. Is there anything else you would like to share about your background, research, or interests that would be relevant to your application?

By submitting this application, you agree that all information provided is accurate to the best of your knowledge. For any questions, please feel free to contact the CTGN coordinator at Ocean.Gallichon.ccomtl@ssss.gouv.qc.ca

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