Request Membership Account Details Username (required)Email Address (required) Choose a password (required) Strength indicator Confirm use of weak password Confirm new password Hint: The password should be at least twelve characters long. To make it stronger, use upper and lower case letters, numbers, and symbols like ! " ? $ % ^ & ). Profile Details Email (required) By default your email address will be hidden from site visitors but will be visible other Network members when they log in. If you prefer to hide your email completely, you can do this at any time by editing your profile. This field may be seen by: All Members Change Who is allowed to see this field? Everyone Only Me All Members Close Title (required) eg Prof, Miss, Dr, Mr etc This field may be seen by: Everyone First name (required) This field may be seen by: Everyone Last name (required) This field may be seen by: Everyone Employment sector (required) Please tell us which sector you work in (in relation to Neuromod+). You may select more than one using shift + click AcademiaCharityClinicalIndustryPolicy-makingRegulatoryn/a: I am a potential end-user of neuromodulationOther This field may be seen by: Everyone Organisation (required) Please enter the name of the organisation that you work for or are associated with (eg your university/company/hospital etc). You can add your department or Centre/lab etc in the next question This field may be seen by: Everyone Department eg Institute of Mental Health, R&D Department, School of Public Health, Bioengineering Department, Comms Department, etc This field may be seen by: Everyone Job title (required) If your connection to Neuromod+ is not related to your job, feel free to put n/a This field may be seen by: Everyone Related website This field may be seen by: Everyone Areas of interest (required) Please enter your area(s) of interest in relation to minimally invasive neuromodulation as keywords separated by commas This field may be seen by: Everyone Disease/disorder of focus If your research or interests focus on a particular disease or disorder, please list it here. Please separate multiple items with commas This field may be seen by: Everyone Do you consider yourself to have a disability? (required) YesNoPrefer not to say This field may be seen by: Only Me Would you describe yourself as: (required) FemaleMalePrefer to self-describePrefer not to say This field may be seen by: Only Me Which ethnic group do you identify with? (required) Asian or Asian British (Includes any Asian background, for example, Bangladeshi, Chinese, Indian, Pakistani)Black, African, Black British or Caribbean (includes any Black background)Mixed or multiple ethnic groups (includes any mixed or multiple ethnic background)White (includes any white background)Other ethnicityPrefer not to say This field may be seen by: Only Me Do you consider yourself an early-career researcher? (required) YesNoPrefer not to say This field may be seen by: Only Me Core ethical values and principles What are some of the core ethical values and principles that you think are important in the Neuromod+ space and that should underpin the Network's activities? This field may be seen by: Only Me Key issues What are some of the key issues that you have encountered, or might foresee (or be concerned about) encountering, in relation to the development of novel neuromodulation technologies? Please feel free to use anecdotal or hypothetical examples to illustrate. This field may be seen by: Only Me Is there anything else you'd like to tell us? Your comments will only be visible to the Network Manager This field may be seen by: Only Me I have read and agree to this site's Privacy Policy.