Engagement À La Protection De La Propriété Intellectuelle

Version ( 10-2007) 0ad6c663bd76cbf4194d86c02d8fd560.doc 1/3 ______DATA ACCESS FORM TO GRIP DATABASES FOR PUBLICATION - DADpub - Or for written authorization for publication following a Data Access form Data for exploratory analyses ______

Procedure to be followed to make a request 1- Complete the form below and save it as DADpub-dd-mm-yyyy-Name, Surname .doc format. 2- Send this file by E-mail to the Coordinator of the Data Management [email protected] Mention the name of your file (DADpub-dd-mm-yyyy-Name, Surname) in the "subject" field.

Each request is analysed. The coordinator transmits the requests to the signatories and to the persons in charge. The data file will be sent to you when all the signatories have authorized the request..

Ownership rights agreement

 I hereby pledge my word to use GRIP data required hereafter for the sole purpose of preparing the project described below.  I give my consent not to reproduce nor communicate in any form the data file, as well as any documentation produced for statistical or research purpose, for the benefit of a third party.

 I pledge my word to submit to the consent of all authors, co-authors and person responsible for the Longitudinal Study, the scientific publication linked to the GRIP data BEFORE any submission ( or re-submission) to editor or conference. The same procedure apply before the presentation of a report, thesis, dissertation, etc.

 I give my consent to provide the GRIP with any document to be published that may outcome from the data. For example, complementary data, programs, etc. The full GRIP Access to Data Policy is available upon request.

I foresee to submit my publication* on :

* ”Publication” include all types of written or oral production accessible by a scientific public

This form, once sent by E- I, the undersigned,… your Name and Given Name …, mail, will be equivalent to Date dd-mm-yyyy hereby declare to have read and approved the previous your signature written indications.

Applicant’s identification

Name, Surname

GRIP Member YES NO (Delete the useless mention) Statute Student at the Master's level (Delete the useless mention) Ph. D. student Post-doc Researcher Researcher (Principal, Associate..) Other (Please specify):

Person (s) in charge (Director for dissertation, thesis, post-doctoral work)

D:\Docs\2017-12-28\0ad6c663bd76cbf4194d86c02d8fd560.doc Version ( 10-2007) 0ad6c663bd76cbf4194d86c02d8fd560.doc 2/3 ______DATA ACCESS FORM TO GRIP DATABASES FOR PUBLICATION - DADpub - Or for written authorization for publication following a Data Access form Data for exploratory analyses ______

Discipline

University

Postal address

E-mail address

Telephon

Project description

Publication Title

Authors

Journal or aimed conference (article, conference, poster…) or type of production

Description of the project

Students: Relate your hypotheses and subject to GRIP studies and/or bibliography

Give 5 specific keywords for this project

Data Request

Study (ies) involved (databases)

Required variables (measures) (add list and specify the age concerned by your study) Please note that all variables mentioned here must be justified by your research hypotheses (dependent or independent variables).

List of variables or measures Age Analyst’ Comments

D:\Docs\2017-12-28\0ad6c663bd76cbf4194d86c02d8fd560.doc Version ( 10-2007) 0ad6c663bd76cbf4194d86c02d8fd560.doc 3/3 ______DATA ACCESS FORM TO GRIP DATABASES FOR PUBLICATION - DADpub - Or for written authorization for publication following a Data Access form Data for exploratory analyses ______

Data file prepared by

Unix path for the data file

Analyst’ Work Time

Authorizations to access

Response’s Deadline : DADpub received on Request for Authorizations Authorized Data sent on

Person (s) in charge (first author for paper or project director for PhD, post- doc, etc.) Electronic signature (E-mail) - validated upon E-mail reception Name(s) (and e-mail if non-GRIP Member)

Researcher(s) responsible for the Longitudinal Study Electronic signature (E-mail) - validated upon E-mail reception - Name(s)

Researcher(s) responsible for measures requested by applicant Electronic signature (E-mail) - validated upon E-mail reception - Name(s)

Other co-authors Electronic signature (E-mail) - validated upon E-mail reception - Name(s)

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