Fuse Associate Membership Application

Personal details
Name * First Last
Email *
Institution
Membership category
Please choose one associate membership category that suits you best

Academic:
Member of academic staff in North East University Member of research staff in North East University Postgraduate student in North East University
Or a member of staff or elected member in:
The NHS Local Government Voulntary sector organisation Other public sector organisation Private sector organisation
What is the reason for you wanting to become an Associate Member of Fuse? *
What do you feel you can bring to Fuse? *
What are your expectations from Fuse as an Associate Member? *
Which of the 6 Fuse Research Programmes do you feel your research would best fit?

For further details see: http://www.fuse.ac.uk/reseasrch
Behaviour Change
Complex Systems
Early Life and Adolescence
Health Inequalities
Healthy Ageing
Translational Research
Any notes?
CV
Please upload a short CV *

(2MB maximum)
Terms and conditions
As an Associate Member you will need to:
• Comply with our Corporate Visual Identity Guidelines if you use the Fuse brand
• Always acknowledge Fuse in any research or other written outputs which describe Fuse work
• Register any Fuse research projects in which you are involved with the Fuse Administrator and update your research outputs on the researchfish system ready for the annual Fuse submission in November each year. *
I agree to these terms and conditions
Once you have completed all fields and agreed to the terms and conditions, click 'submit' and your application will automatically be sent to the Fuse Administrator. Your browser will then be re-directed back to the Fuse homepage.
Data Protection Statement

The data collected will be accessed by the Fuse Administration and Management team to process your application. Once your application has been accepted your name will appear on the Fuse website: http://www.fuse.ac.uk/people/associatemembers and your CV retained on file. If at any point you wish to withdraw your application and related information please contact fuse@ncl.ac.uk. For full details of the Newcastle University data protection statement please see http://www.ncl.ac.uk/data.protection/

Fuse Associate Membership Application

Fuse Associate Membership Application

Personal details

Membership category

Which of the 6 Fuse Research Programmes do you feel your research would best fit?

CV

Terms and conditions

Once you have completed all fields and agreed to the terms and conditions, click 'submit' and your application will automatically be sent to the Fuse Administrator. Your browser will then be re-directed back to the Fuse homepage.

Data Protection Statement