Review Profile - Brain Awareness Week

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Prefix

First Name*

Last Name*

Email*

Title

Department

Partner Institution Details

Institution Name*

Institution Type*

Address 1 (no P.O. box)*

Address 2 (no P.O. box)

Address 3 (no P.O. box)

City*

Province

Country

State (if US is country)*

Postal Code

Telephone Number*

Extension

Institution Website (URL)

Brief Description of Institution*

We collect this data to process your request to register to be a Brain Awareness Week partner and to send you information about BAW deadlines and requests. We also use it, aggregated with other partners' information, to compile anonymized statistics about the BAW campaign. We may share these statistics, with no personally-identifying details, publicly. We also use your data to reach out to partners for interviews, and to find partners to highlight on our website and social media. On occasion, we share their data with other partners who are looking for an organization in their area to collaborate with. Your institution’s name will be publicly listed as a Brain Awareness Week partner on our website, your name appears on the event, report, and order forms

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