Social Science Survey Researcher COI Disclosure
Researcher Information
Full Name
Position/Title
Institution/Organization
Email
Survey Project Information
Survey Title
Funding Source(s)
Project Summary
Disclosure of Potential Conflicts of Interest
Financial Interests (e.g. grants, fees, equity)
Non-Financial Interests (e.g. professional affiliations, advisory roles)
Other Potential Conflicts
Certification
I certify that the above information is complete and accurate to the best of my knowledge.
Signature
Date