The EEG based Brain-Computer Interfaces for Object Recognition Experiment
Hello, I am Daniel Leong from the Computational Intelligence and Brain Computer Interface Laboratory at UTS. If you are reading this, then you have responded to our Call for Participants advertisement. Thank you for taking the time to respond and hopefully participate in our experiment. As mentioned, you will be compensated for your time. This experiment is approved by UTS HERC ID ETH20-5519

As part of our research, we are finding a robust EEG biomarker of object recognition based object identification (OR-based OI) and investigate the robustness of the OR based OI under various appearances constraints. This experiment will involve recording your biosignals (EEG / Brain Activity) while performing the object recognition task. Before we schedule you a time slot, there are a few questions we will need you to answer to ensure that you are eligible to participate in this experiment.

This experiment will be host at the CIBCI Laboratory located at UTS, Building 11, level 6. (CB11.06.400).

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Full Name *
What is your age? *
Existing Medical Conditions
For privacy reason we will not be collecting information on any existing medical conditions. Please find below a list of medical condition categories. Unfortunately, for safety purposes, if you do have any of the listed conditions you will not be eligible to participate in this experiment. If you are unsure about your eligibility, please feel free to state below in the response area provided or contact me directly via email.

You have been invited to participate in this study because you have shown interest and agree to following conditions:

• Should not be currently taking any psychoactive medication/drug as follows:
o Anesthesia medication/drug to block physical pain, e.g., used during medical procedures like surgery;
o Pain management medication/drug to manage the subjective experience of pain (e.g., aspirin, ibuprofen, etc.);
o Mental disorder medication/drug to control mental and emotional disorder (e.g., antidepressants);
o Any medication/drug, which affects the central nervous system;
o Any medication/drug, which blocks the sensation in the central nervous system; and
o Should have no prior history of drug or alcohol abuse, neurological, psychiatric or sleep disorders;
• Should have no prior history of drug or alcohol abuse, neurological, psychiatric or sleep disorders;
• Have a sleep-wake pattern where you would typically rise by at least 9 am each morning, for a duration of at least 6 hours sleep per night or longer;
• Be a non-smoker; and
• Refrain from any alcoholic drinks and caffeinated products 24 hours before each session.
If you are unsure about any questions above, you can ask in this space provided here. You may also privately email the details (daniel.leong@student.uts.edu.au), if you are uncomfortable with discussing through this form.
What is your preferred method of contact? *
Please provide details for the chosen method of contact, i.e. mobile number, email address etc. *
Preferred time slot during the week (Experiment is roughly 2 hours). Please select ALL available.
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11 am
12 pm
1 pm
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3 pm
4 pm
5 pm
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Tuesday
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Friday
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Please write here, if there are any specific details in regards to preferred time slots, e.g. avoid this week, or these dates.
Compensation will be provided in a gift card form. Which email will you prefer to receive the egift card? We will send you a few gift card options in the future. *
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