Became a Volunteer

    General Information
    Last Name* :
    First Name* :
    Birth Date* :
    Height (cm)* :
    Weight (kg)* :
    Sex* :
    Dominant fand* :
    Mother tongue* :
    Speak french* :
    Last qualification level* :

    Scientific rigor in all research work means that groups of people with a comparable profile must be put in parallel, which is why in some of our studies, we must recruit volunteers in order to perform brain MRI images under similar conditions ( age and level of education).
    See: What qualification levels mean (gov.uk)
    Bra size/cup :

    Our research topics are varied and may, for example, relate to breast cancer screening. In this context, we need to know your chest size and your cup size (and therefore your bra size).
    Remarks :

    Contact
    Adress* :
    ZIP Code* :
    City* :

    Coordinates
    Cell Phone Number* :
    Phone Number:
    E-mail* :

    Consentents
    Do you agree to participate in an unpaid study :
    By using this form, you agree to the storage and manipulation of your data by the CIC-IT of Nancy :