New Research Registration

Please register your research project with MNC. After completing this form, you will be emailed a Research ID which you will need to complete the Scheduling Request Form in order to reserve use of the MRI, Mock or MNC rooms.

Principal Investigator *

UMD Email *

Phone Number *

IRB Number *

IRB Title *

IRB Start Date *

Month

Day

Year

IRB End Date *

Month

Day

Year

Workday Spend Worktag *

Working Title *

A 3-4 word title to easily identify your study at the MNC. Ex: The study entitled 'Behavioral and Magnetic Resonance Imaging Studies of Emotion and Cognition' would have a working title 'Emotion and Cognition'.

Department and College *

Financial Administrator for Project

Name *

Title *

Department and College *

Phone Number *

Email *

Lab Manager / Person(s) Managing Subjects at MNC

Name *

Title *

Department and College *

Phone Number

Phone Number (Cell) *

Email *

Additional Contact

Yes

Name

Title

Department and College

Phone Number

Phone Number (Cell)

Description

An optional description of the study so it may be added to the "current research" page.

Question/Comments