جامعة أم القرى

جامعة أم القرى

UQUDent Research Request Form

     من : - 2021/02/20 م , إلى : - 2030/02/12 م

توجد نسخة محفوطة من النموذج .. لا تنس إرسال النموذج بعد الانتهاء من إكمال كافة الحقول المطلوبة لمسح النسخة المحفوظة. اضغط هنا

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    UQUDent Research Request Form

    * Research title

    * The research type

    * Research Proposal

    Including the methodology (PDF or Word)

    الامتدادات المسموح بها : csv, doc, docx, pdf, ppt, pptx, ppsx, txt, xls, xlsx
    الحجم المسموح به : 1024
     عرض

    * The institutional review board letter (IRB) / Ethical Approval

    , PDF please. In case no IRB approval is required please submit the decision letter.,

    الامتدادات المسموح بها : csv, doc, docx, pdf, ppt, pptx, ppsx, txt, xls, xlsx
    الحجم المسموح به : 1024
     عرض

    * The Name of the Principle Investigator

    in English please


    * Is there anyone of the Authors works at Umm Al Qura University - Faculty of Dentistry

    If Yes please Specify Him/ Her in the next box


    * Co Authors

    for example 1-.............. 2-.........* works at UQU- Faculty of Dentistry 3-.........


    * Supervisor's Name

    In English please


     Which Machine/s or device do you need to use ?

    Applicant's Information

    * Applicant's name

    * Applicant's Email

     Applicant's Mobile number

    966XXXXXX


    * Applicant's Position/ Place of work/ University/ College

    for example: Student/Umm Al Qura University/ Faculty of Medicine or Periodontist/ King Faisal Hospital/ Ministry of Health etc.


    Agreement

    I agree to the terms of use which mandates aknowledging UQUDent research lab in the publication and/or including at least one of UQUDent staff members with a relevant qualification in the study as a participant after fulfilling the required criteria for participation in the publication. Also, i have been informed that UQUDent is not responsible for providing the study with any material and the approval is merely for using the available lab equipments.




     
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