Research Committee
Application form for Chair position
Full name
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Title
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Please Select
Dr
Prof. Dr
Institution
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City
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Country
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Mobile Phone
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Country Code
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Area Code
Phone Number
ESAIC Membership number
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Email
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example@example.com
Secondary email (if any)
example@example.com
1. Qualification and motivation to become Chair of the Research Committee
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0/1500
2. Current and substantive positions in the past 5 years
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0/1500
3. Experience as researcher - Experimental Research
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0/1500
4. Experience as researcher – Clinical Research
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0/1500
5. Experience in reviewing research
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0/1500
6. Experience in public funding / EU funding
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0/1500
7. Successful Grants applications in the past 5 years (type of grant, amount of grant, from which institution,…)
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0/1500
8. What is your experience as peer reviewer of research articles submitted to journals for publication
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0/1500
9. What is your experience as peer reviewer of Research grant applications (including the total amount of money from third party as well)
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0/1500
10. Total number of listed scientific publications
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11. In how many of the published papers are you first or last author ?
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12. Personal Hirsch Index (using Scopus database)
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13. Any exceptional publications note worthy ?
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0/2000
14. Please declare any conflict of interest ? i.e. relationship or arrangement with a commercial company, direct or indirect, that could be reasonably considered to affect the work in the research committee. This includes, but is not limited to, financial relationships, advisory positions, receipt of grants/research supports, receipt of honoraria or consultation fees, participation in a company sponsored speaker's bureau, stock shareholder, and spouse/partner financial relationships with a commercial company
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0/1500
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I confirm that I have the necessary time available to commit to Chair the Committee and appreciate that if I fail to provide the Committee with the required support, my three year tenure will not be renewed
Please read the ESAIC Code of Conduct before proceeding:
ESAIC Code of Conduct
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I hereby confirm that I have read and understood the ESAIC Code of Conduct
Upload your CV (maximum 2 sides of A4)
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Upload your list of publication (preferably downloaded fromPubMed)
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Upload a short outline (maximum one page A4) of your perspectives as RC chair
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Date
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