Notice of Intent
Students and Early Career Researchers (ECRs) are invited to submit their work to the Patient Safety Design Competition being held at 21 triennial congress of the International Ergonomics Association (IEA 2021).

Please use this form to submit the 'Notice of Intent' for IEA2021 Design Competition. Ensure you have read the eligibility criteria before submitting (https://humanfactorsinterestgroup.files.wordpress.com/2020/08/iea-2021-design-competition-full-description-gen.pdf).

*Note: ECRs are considered to be those who have been working in industry for 5 years or less. All team members must be current students or ECRs.

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Please provide an email address which will allow us to contact your team about its submission. *
Please select your track. *
Please enter your working Project Title (you are not committed to this title) *
Please provide a brief description of your project (250 words MAX). *
Please select the category of your team: *
Please enter the name and affiliation of Team Member # 1 *
Last Name, First Name (Affiliation, Country)           e.g. Parker, Peter (Empire State University, USA)
Status for Team Member # 1 *
Please enter the name and affiliation of Team Member # 2 *
Last Name, First Name (Affiliation, Country)           e.g. Parker, Peter (Empire State University, USA)
Status for Team Member # 2 *
Please enter the name and affiliation of Team Member # 3
Last Name, First Name (Affiliation, Country)           e.g. Parker, Peter (Empire State University, USA)
Status for Team Member # 3
Clear selection
Please enter the name and affiliation of Team Member # 4 (if applicable)
Last Name, First Name (Affiliation, Country)           e.g. Parker, Peter (Empire State University, USA)
Status for Team Member # 4 (if applicable)
Clear selection
Any final thoughts/comments regarding your submission?
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