CTTP Registration

Personal Information

Language Selected

Title*

First Name*

Last Name*

Full Name*

First NameLast Name

Preferred Name:

City/Town:*

Province*

Select the institution you are part of*

Enter your selected institutional e-mail address, which will be used to access the Learning Management System (Validation)*

I do not have an institutional email address

Preferred Email Address*

This field is automatically filled upon email validation

If you selected COMMUNITY PARTNER/PATIENT/CHARITY, BIOTECH, BIOPHARMA, CRO, or OTHER above, please enter the name of the institution/organization you are part of*

If you entered COMMUNITY PARTNER/PATIENT/CHARITY, BIOTECH, BIOPHARMA, CRO, or OTHER above, please insert your preferred Email Address (validation)*

Preferred Email Address*

This field is automatically filled upon email validation

In which language do you prefer to access the courses?*

EnglishFrench

Are you an awardee?*

Yes (select 'Yes' ONLY if you are an awardee of the latest announced cycle)No

Award Year

Select your type of award

Studentship / FellowshipInternship

Award Category

Please specify the CTTP administering the award

Registration Information

Professional affiliation:*

YesNot Applicable

Please specify the type of organization (affiliation)*

Public health (authorities/systems, hospitals, research centers/institutes)Private sector (biotech, biopharma, contract research organization)Non-profit organizations/charities

Current Position (employed or volunteer, if applicable)*

Which group of CANTRAIN learners best describes you today?*

Graduate or Postdoctoral Trainee.Clinical Research Professional – e.g., Research Assistant/Associate, Coordinator, Nurse/Clinical Research Coordinator, Manager, Director etc.Trialist – Clinicians, Scientists, and Trial Methodologists.Community Partner – i.e. Patient partners, patient advocates.

Which of the following best describes your motivation to complete the CANTRAIN Common Core Foundation?*

To earn a CANTRAIN Certificate of Completion.To learn about the topic(s) covered.To engage with other learners.

How experienced are you with clinical trials?*

1

2

3

1 is I'm new to world of clinical trails, 3 is Experienced

How familiar are you with online learning?*

1

2

3

1 is Not at all!, 3 is Experienced

Quelle est votre expérience en essais cliniques?*

1

2

3

1 is I'm new to world of clinical trails, 3 is Experienced

Quelle est votre familiarité avec l'apprentissage en ligne?*

1

2

3

1 is Not at all!, 3 is Experienced

Self-Declaration

The following questionnaire was developed collaboratively by the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC), the Social Sciences and Humanities Research Council (SSHRC) and the Canada Foundation for Innovation (CFI). The self-identification questionnaire is a central piece of the agencies' commitment to equity, diversity and inclusion (EDI).

These data provides information on the diversity of the population applying for and receiving agency funds and increases the granting agencies' capacity to monitor their progress on increasing EDI in their programs, to recognize and remove barriers, and to design new measures to achieve greater EDI in the research enterprise. As a federally funded enterprise, CANTRAIN collects these data in order to provide aggregate reporting to the funding agencies for this purpose.

Access to these data is strictly limited to a small number of CANTRAIN staff with the appropriate training and security clearance on a need-to-know basis. Self-identification information is not part of your application and will be neither accessible to, nor shared with, other CANTRAIN staff, partners or members.

EDIA Principles

Please consult: Equity, Diversity, Inclusion and Accessibility Principles

Self Declaration

Please consult: Self-identification data collection in support of equity, diversity, and inclusion

I agree to provide my self-declaration information regarding age, sex, indigenous status, and other demographic details in an aggregated form for internal assessment and statistical purposes by the co-funders. I understand that this information will be collected anonymously and used solely for improving equity, diversity, and inclusion within our programs.

Consent & Signature

Disclaimer

The recommendations, and e-learning and e-training resources found within the CANTRAIN website and learning management system for Clinical Trials Training are intended to inform and instruct various streams of learners and other stakeholders who are interested or deliver services related to the conduct of clinical trials.

The best available and relevant evidence and science have informed the content of these courses.

Patient, parents, and/or caregivers may wish to bring their healthcare and other providers’ attention to these resources when considering enrolling in clinical trials. Healthcare professionals should also consider their own judgment, and the preferences of their patients, in their decisions relating to the conduct of clinical trials.

The CANTRAIN project team, designers, developers, contributors, mentors, subject / content matter experts and supporting partners shall not be liable for any damages, claims, liabilities, costs, or obligations arising from the use or misuse of these courses including loss or damage arising from any claims made by a third party.

Any citations or changes must be accompanied by the statement: “Adapted from CANTRAIN curriculum with/ without permission,” according to whether or not permission was sought and/or given.

Signature*

Date*

Date

Please verify that you are human*