LSHTM Open Data Kit Server Request Form
This form should be used to request an ODK@LSHTM account
Email address *
Personal Details
Your Name *
Your answer
Faculty (within LSHTM) *
Which Department are you linked to
Your answer
Project Details
The short name will become your unique project URL. (Please avoid any non-alphanumeric characters and whitespace)
Project Name *
Your answer
Short Name (No underscores, punctuation marks or spaces) *
Your answer
Description of project *
Your answer
Pay What You Can (PWYC)
We operate on a tiered Pay What You Can (PWYC) model.

You can apply for an account with ODK@LSHTM and you will not have to pay for it if you are unable to do so.
We encourage all grant funded researchers to make a contribution to our costs.
Payments can be made retroactively when grant income is pending and all users are encouraged to include a line for ODK use on grant applications.

We recommend the following minimum payments

MSc projects : £0 (maximum six month period)
PhD projects (self funded) : £0
PhD projects (grant funded) : £250 / year
Any other grant funded research : £500 / year


The ODK project is not for profit and all money that you contribute will be used to keep the system going.
How much would you like to pay? (GBP) *
Your answer
If you are making a non-zero PWYW payment, please select how you would like to pay. *
Please give the internal grant code or details of the invoice address *
Your answer
Ethics
Please give the name of the institution(s) granting ethical consent for the project *
Your answer
Has ethical consent been granted for the study protocol? *
Ethics Reference Number (If ethical consent has not been granted, enter 'pending') *
Your answer
Study Sites
Please enter details of Countries in which you will be working
List countries (separate with commas) *
Your answer
Funding
List funding agencies (separate with commas) *
Your answer
List Grant Codes and awarding agencies (separate with commas) *
Your answer
Context
Is this project part of a PhD, MSc, Dphil or similar? *
Is the study part of a clinical trial *
Principal Investigator / Line manager / Project Supervisor
Please give the name and email address of the principal investigator/ project supervisor of the study
ALL Students must enter the name of an LSHTM staff member who is willing to act as PI
Principal Investigator Name *
Your answer
Principal Investigator Email address *
Your answer
Dates
Please enter the expected dates for this project
Start Date *
Your answer
End Date *
Your answer
Non LSHTM applicants
Please enter the name and postal address of your institution
Your answer
Acknowledgement
We request that you acknowledge our support in research papers and reports that come from studies using LSHTM Open Data Kit

If you are happy to do so, please paste this text in to the acknowledgments section of your outputs…

“Electronic data solutions were provided by LSHTM Open Data Kit (odk.lshtm.ac.uk).”
Consent for use of personal data
We need to keep a record of your personal data (Name, email etc) in order to be able to provide our services and to contact you about your project. We may also occasionally wish to contact you to seek your opinions and experiences in surveys, to obtain case studies and as part of our public engagement or dissemination work. We can only do this is you provide explicit consent using the questions below
Consent for data storage *
I consent to my data being stored by the LSHTM Open Research Kits team, LSHTM Information Technology Services and on request by senior management of LSHTM. I understand that no data will be passed on to any third parties without additional consent
Required
Service critical communications *
I consent to being contacted by the LSHTM Open Research team for service critical updates and operational reasons
Required
Surveys and Case Studies *
I consent to being contacted by the LSHTM Open Research team for surveys, case studies, public engagement and other matters that could improve service provision in the future or raise the profile of the project or the school.
Required
Newsletters/ Service Updates / T&Cs *
I consent to being sent occasional email newsletters, service updates and updated terms and conditions.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service