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 Account Registration

 * Pirate ID or UserID:
     
  Salutation:
 * First:
  Middle:
 * Last:
  Suffix:
     
 * E-mail 1:
  E-mail 2:
     

  
  * Please select all applicable statements regarding your use of 
     the ePIRATE system.  

 Name
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 *  Institutional Affiliation:
 

Other Institution
(if not listed above):
 


 


 *


ECU School/
Department
:


     If you are not affiliated with ECU, please select "Other Organization/Institution".
     
 
Title:

 
  Degrees/
Credentials:

 
 
   
ECU users will use their same PirateID and password that is used for email and OneStop.  ECU users will not be able to submit a new study or access any current studies until a user role has been assigned by the OHRI office.  ECU users will receive an email notifying them when this user role has been created. 

Non-ECU users will create their own UserID and will receive a temporary password by e-mail after they register. Upon first login, they will be prompted to change that password. 

All users will need to set-up their profile once the user role has been set.

 
 Phone Numbers
                                                                                   Addresses
 * Office:
  Mobile:
     
  Fax:
     
     
     
 
*  Address 1:
  Address 2:
  Mail Stop:

 

  City:
  State:   Zip:
  Country:
   
     
   

 

 

     
           
     

* Required    

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ECU

University & Medical Center Institutional Review Board
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