Denning Ataxia Center Membership Application

Please note: All membership applications must come from Northwestern University faculty. All applications that are accepted for membership will have a faculty profile link visible on our member page. For any questions about membership or applications questions/requirements please contact rachael.odonnell@northwestern.edu.

First Name
Last Name
Middle Name/Initial
Degree
Email
Department
Division
Lab you are associated with (if applicable)
Title
Institution (NU, NMH, Lurie, SRAL, other)
Campus (Chicago/Evanston/Other)
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone Phone - ### - ### ####
Research Statement
Please provide a brief statement (2-3 sentences) describing your interests in the cerebellum or ataxia research.