Application Form

1 Login

2 Profile of Principal Investigator

First Name *

Last Name *

Age *

Gender *

Email *

Mobile *

Mailing Address *

Country *

State *

City *

Pincode *

IADVL Membership Number *

Brief CV of the Brief CV of the Principal Worker (including publications) in pdf format *

Degree *

Speciality *

Affiliated Institute / Hospital *

Present professional activities *

Name the IADVL or other research projects that the principal worker was or is engaged in:*

3 Upload Part 1 of the Application form (only as a PDF document)

Upload Part 1 of the Application form (only as a PDF document) *

4 Upload Part 2 of the Application form (only as a MS Word document)

Upload Part 2 of the Application form (only as a MS Word document) *

5 Upload Annexures (PDF or JPEG document) if applicable

Case record form ( pdf / Image )

Questionnaires ( pdf / Image )

Consent forms (in English and local language) ( pdf / Image )

CV of co-investigators (if a multicentric study) ( pdf / Image )

Consent from HOD (if applicable for co-investigator) ( pdf / Image )

Ethics committee approval (if obtained) ( pdf / Image )

CTRI registration submission acknowledgement (if obtained) ( pdf / Image )