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* 1. What is your full name?

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* 2. Please provide your email address.

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* 3. Designation or current job position (i.e., graduate student, professor, program manager)

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* 4. Area of interest in substance use research. Ideally including a few keywords around your area(s) of interest

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* 5. What is your research methodology?

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* 6. Please provide your position/role and your current organizational affiliation.

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* 7. How did you hear about CRISM?

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* 8. What interests you about being a member of the CRISM network / Ontario node?

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* 9. Are you interested in working with the Node to develop new CRISM projects and initiatives? These could include research projects and knowledge exchange activities. If yes, please identify a topic of particular interest to you in the space below.

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