Question Title

* 1. Full name / Nom complet

Question Title

* 2. Designation or current job position (i.e., graduate student, professor, program manager) /  Titre ou fonction actuelle (p. ex. étudiant, professeur, coordonateur de programme)

Question Title

* 3. Area of interest in substance use research. Ideally including a few keywords around your area(s) of interest / Domaine d'intérêt / expertise en recherche sur la consommation de substances (mots-clés)

Question Title

* 4. What organization are you affiliated with? / Affiliations (institution à laquelle vous êtes associé-e)

Question Title

* 5. Contact information / Information de contact

Question Title

* 6. Which CRISM Working Groups would you be interested in being involved with? / À quel Groupe de travail du pôle souhaiterez-vous participer?

Question Title

* 7. How did you hear about CRISM ? / Comment avez-vous entendu parler du CRISM / pôle Québec-Atlantique?

Question Title

* 8. What interests you about being a member of the CRISM network / Quebec-Atlantic node? / Pourquoi souhaitez-vous devenir membre du pôle Québec-Atlantique / réseau CRISM ?

Question Title

* 9. Would you like to subscribe to our newsletter? / Souhaitez-vous vous inscrire à l'infolettre du pôle ?

T