REQUEST FOR SLOTS ON THE CBU Trio MRI

Name of  experiment:  									

Is this a new proposal, or request for more slots for an existing experiment?  			

Researchers involved:   									

Primary contact tel (and email, if not CBU): 						

Funding source (if not CBU): 								

If none of the Researchers is an MRC employee, do you have insurance? 			

When was the project proposed at the IIG?  					

What is your LREC Ethics Reference? 							            

How many subjects are you testing?  	    			

How many pilots (additional to above) do you want to run (at least 1 week beforehand)?  	 	

Are the subjects patients? If so, please detail. 			

From where will you draw subjects? 			

How many 15min time units per subject are you requesting?  	    			

What is the total EPI time per subject?  	    			

Preparation time (outside scanner)? 				

Any non-standard setup/equipment/procedures/sequences (please detail)? 			

Which headphones will you be using (if any)?				

When do you propose to run the experiment? 						

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Proposal background & basic procedure

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Scanning protocol

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Hypotheses and Predictions

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Suggestions from IIG Meeting

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