NAS Agreement Form

Please complete the following and submit in order to access the data and codebooks.

This form must be completed and submitted in full. If you have any questions or concerns, please contact Study Director Dr. Priscilla Martinez.

FIRST NAME*
LAST NAME*
PHONE*
EMAIL*
INSTITUTION / ORGANIZATION*
Provide the institution, organization or company that you work for or are affiliated with.
POSITION / TITLE*
NAS DATASETS REQUIRED*
Please select all the datasets you're requesting. If you're using a PC, hold down the CTL key to select more than one option. For Mac users, hold down the COMMAND key to select multiple datasets.
PROJECT DESCRIPTION*
Please describe how you will use the data, including research question, aims and dissemination plan. Also include research partners and their institutions.
TERMS OF USE*
By checking "I have read and agree to the terms of data use", you will be bound to the following: 1. Acknowledge and disclose on all publications, presentations, reports and/or other dissemination materials as follows 1) Data collection was funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health under award number P50AA005595; 2) Data were collected by the National Alcohol Research Center at the Alcohol Research Group, a program of the Public Health Institute; 3) Data will not be shared with individuals or organizations not listed in the project description; and 4) Subcontractors will adhere to the agreements listed here.
- I have read and agree to the terms of data use