CONNECT-VAX Potential Partner Identification Form

Quick form: This profile is intended for partner identification and consortium formation. Fields marked * are required.

1 Basic Information

Full Name *

Country *

Institution / Organisation *

Department / Unit

Position / Designation *

Email Address *

Telephone / WhatsApp Contact

2 Research Profile

Main Area of Research Expertise *

Vaccine Research Area / Theme of Interest *

Specific Skills / Expertise You Can Contribute *

Briefly describe the capabilities you would bring to a collaborative research team.

Preferred Role in a Collaborative Proposal *

Current / Previous Relevant Research

3 Collaboration Interest

Interested in joining a cross-country CONNECT-VAX research team? *

Already part of a team preparing a CONNECT-VAX proposal? *

Countries You Are Interested in Collaborating With

Uganda Kenya Tanzania Sierra Leone

Additional Information for Potential Partners

4 Consent

Only professional information relevant to research collaboration should be submitted. Avoid entering confidential, sensitive, or unpublished research information.