PART A: to be completed by the applicant ONLY
Declaration: to be completed by the applicant
The information supplied in this application form is both true and complete. Where applicable, I consent that PanACEA representatives may seek clarification regarding my professional and academic skills. I understand that the PanACEA working group may also wish to send me a notification email once this form has been received and I am happy for them to do so.
END OF PART A
Please ensure that the next section of this application form is completed by your supporting principal investigator or other referee.
PART B: Supporting information to be completed by the applicant's PI or other referee