Conflict Consortium Information Request
Basic Information
Name *
Address
Address line 2
Country
City
State
Zip/Postal Code
Affiliation *
E-mail *
Phone
Twitter
Facebook
LinkedIn
Website
Blog
Fields of Interest
Check all that apply: *
Required
Geographic Interest
Does your research concern global patterns?
Clear selection
Does your research focus on particular countries or regions?
(If yes, you will have the opportunity to specify on the following page.)
Clear selection
Fieldwork Experience
Country 1
City/Region 1
Year(s) 1
Year(s) research was conducted 1
Year(s) of interest to research 1
Country 2
City/Region 2
Year(s) research was conducted 2
Year(s) of interest to research 2
Country 3
City/Region 3
Year(s) research was conducted 3
Year(s) of interest to research 3
Country 4
City/Region 4
Year(s) research was conducted 4
Year(s) of interest to research 4
Country 5
City/Region 5
Year(s) research was conducted 5
Year(s) of interest to research 5
Biography
Please add a short biography (limit 200 words)
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