Affiliate Membership Application

MOHD affiliate membership offers the opportunity for individuals who are not MOHD members to participate in and contribute to the scientific activities and mission of the MOHD Consortium. Before applying, please see the MOHD Affiliate Membership Policy for more details about affiliate membership eligibility criteria, benefits, and responsibilities.

 

Interested investigators should complete and submit the form below. Submissions are reviewed by the MOHD Steering Committee. An application can come from an individual researcher or a contact PI on behalf of a single institutional research team/lab.

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Email *
Name (First Name, Last Name) *
Institution *
Role/Title *
Team members (Names and emails)

Are you applying from a private sector and/or for-profit entity?

(If Yes, application may require additional review by NIH program office.)

 *

Are you offering cost-free or in-kind services to the MOHD Consortium?

(If Yes, application may require additional review by NIH program office.)

 *
MOHD working groups in which you are applying to participate (check all that apply) *
Required

Provide a concise summary of your expected contributions to MOHD.

 *
Please include:
  • A brief description of why you would like to be considered for MOHD Affiliate Membership
  • Specification of expertise or capabilities relevant to MOHD
  • Where applicable, information on funding available to conduct any proposed research 
  • Specification of MOHD projects or Working Groups on which you intend to participate:    
               -  describe expertise and planned roles on the project or group
               -  a brief note outlining mutual understanding of this role by the project or Working Group leader(s)
Note that if you are proposing a new project, then you may be required to submit an ancillary study proposal after becoming an affiliate member.  Please see the relevant policy here.
As an affiliate member you will need to sign the MOHD Code of Conduct and the Data Sharing Agreement if you are approved.
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