Alliance Membership FOrm

Welcome to the Alliance for Immunology Innovations’ application form. Please provide the following information to apply for membership. This form is intended for researchers and innovators in the field of immunology interested in collaboration, commercialization, and advancing immunological research. Please also download the below membership agreement document and upload the signed version in the membership form.

Alliance for Immunology Innovations (AII) Membership Form

Alliance for Immunology Innovations (AII) Membership Form

Full Name(Required)
Enter your full name as you would like it to appear on Alliance materials.
Enter your current title or role (e.g., Principal Investigator, Research Scientist, CEO).
State the name of your affiliated institution or organization.
Enter the best email address for Alliance-related communications.
Link to a professional profile or institutional page.
Briefly describe your main areas of research or innovation and any specific immunological interests. (non-confidential)
List any Non-Confidential patents or intellectual property summary you hold or have contributed to.
Areas of Interest for Collaboration(Required)