MEMBERSHIP FORM – Toronto Cannabis and Cannabinoid Research Consortium Name* First Last Degrees*Academic degree(s) AND/OR research degree(s)Academic Rank*ProfessorAssociate ProfessorAssistant ProfessorProfessor EmeritusLecturer/InstructorResearch Site Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Email* Phone*School of Graduate Studies Appointment*Yes-FullYes-AssociateDon’t holdFaculty and Department of primary appointment at the University of Toronto*Department(s)/academic unit(s) of cross-appointment at the U of T*Department/division at the affiliate teaching hospital (if applicable)*Website link to research/lab Please provide below a brief description of your health research as it relates to cannabis and cannabinoid research* (max. 250 words)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 HealthNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
