MEMBERSHIP FORM – TC3 Toronto Cannabis and Cannabinoid Research Consortium Last Name* Last First Name* First Academic Rank*ProfessorAssociate ProfessorAssistant ProfessorProfessor EmeritusLecturer/InstructorInstitution*Faculty of primary appointment at the University of Toronto*Department of primary appointment at the University of Toronto*Email* Phone*Research Site Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code School of Graduate Studies Appointment*Yes-FullYes-AssociateDon’t holdDepartment(s)/academic unit(s) of cross-appointment at the U of T*Department/division at the affiliate teaching hospital (if applicable)*Include up to 10 key words that describe your research*Please indicate which of the following research pillars and subpillars align with your research (Press and Hold "CTRL" key and left click for multiple selections).*Preclinical: Pharmacology and ToxicologyPreclinical: ChemistryClinical: Mental HealthClinical: TherapeuticsHealth Policy / Public HealthPlease provide below a brief description of your health research as it relates to cannabis and cannabinoid research* (max. 250 words)Website link to research/lab EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
