<addindividual>

From Neuropunk.Org

Add an Individual to the Database

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Items with a * are required.

Title:	Mr. Ms. Dr. Prof. Dr.
*First Name:
Middle Initial:
*Family (Last) Name:
Suffix:	(Jr., Sr., II, III, etc.)
Degree:	AS BS BA MS MD PhD DSc MD/PhD MD/DSc (Please select the highest degree received)
Contact Information (Please list only company/institutional contact information, no private residence or personal e-mail information please)
*Company/Institution:	Arizona State University California Institute of Technology Fraunhofer-Institut für Biomedizinische Technik - IBMT Georgia Institute of Technology National Cardiovascular Center Research Institute RIKEN Brain Science Institute University of Michigan TC Design Group, LLC If your Company/Institution is not listed you can add it now, then reload this form.
Division/Department:
*Address Line 1:
Address Line 2:
Address Line 3:
*City:
*State/Province/Canton:
*Postal Code:
*Country:	Select Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua/Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Chad Chile China Colombia Congo Brazzaville Congo Democratic Rep. of Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine Autonomous Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saipan Samoa Saudi Arabia Senegal Serbia-Montenegro Seychelles Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka St. Kitts/Nevis St. Lucia St. Vincent Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Tonga Trinidad/Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands U.S. Virgin Islands United States of America Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis & Futuna Yemen Zambia Zimbabwe
*Region:	Select Region Africa Arctic/Anarctic Asia Australia Central America & Caribbean Europe Middle East North America Russia South America
*Telephone:	Ext.:
Fax:
Email Address:
Work Homepage	(e.g. http://www.myworkhomepage.edu)
Personal Homepage	(e.g. http://www.mypersonalhomepage.net)

Short Biography:
Please list education and other training with dates. This section should read as one might introduce the individual to an audience at a professional meeting.

Current Work:
(No more than 2 paragraphs please)

Affiliations:
(Professional Organizations, universities, research groups, businesses, etc. with which the individual is affiliated)

Using Medline/PubMed format, please list the four most recent publications relating to Neural Engineering. A link to PubMed will be automatically inserted at the end of the generated page to permit all of the individual's publications to be displayed

Publication 1:

Publication 2:

Publication 3:

Publication 4:

US Patents:
(List US Patent numbers separated by a comma or a space)

*Please list the source(s) used to compile the information on this page. (e.g. Homepage URL, Published CV, Faculty web page URL, etc.):


Classification Information
(please chack all that apply)

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The person is a:
Professor/Teacher
Researcher - Anyone who conducts research that is not a Student or a PostDoc
Physician

PostDoc
Graduate Student
Undergraduate Student

The person's work is performed in the:
Academic Sector (public and private institutions of higher learning)
Private Sector (business and industry)
Government Sector (e.g. National Institutes of Health but not military agencies)
Military Sector

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*By checking the appropriate box below I certify that I am the above listed individual or their authorized agent, and that I/we agree to comply with the terms of the submission guidelines and agree to the grant of rights as set forward therein.
I am
The individual whose information is listed above
OR
An authorized agent of the individual. Agents Name

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