DAC application form for KU Leuven researchers to submit data to EGA

Details of principal investigator

First name

Last name

E-mail

Affiliation

KU Leuven

UZ Leuven

VIB

Name of the contact person at the PI’s research group

Email of the contact person at the PI’s research group

Research KUL/UZ dataset

S-number

Please fill in the correct Snumber so that the amendments are linked to the correct study. Complete with the 5 digits. Start with S. For example S12345.

Description and source of the dataset

Please answer the following questions:

General description of the dataset (eg WGS, WES, DNA methylation data, SNP RNA, …)?
Based on which samples was the dataset generated?
Was the dataset generated through an ICF of KU Leuven?
Or is the dataset generated based on samples obtained from an external party (please specify this party)?

Answers

If the dataset was generated based on samples from a third party and/or the dataset was generated in collaboration with third party(ies), then depositing the data at EGA may be subject to legal contract(s) with such third party(ies). Through which legal department were the contracts negotiated in the study, if applicable?

CTC

DOC

LRD

Name of the contact person in the legal department

Type of agreement/contract(s) applicable to the study, original samples and/or generation of the dataset

Collaboration agreement

Consortium agreement

Service agreement

MTA

DTA

Other

Name of the counterparty(ies) in the contract

Ethics Committee Research UZ/KU Leuven

I declare that the study has been approved by the Ethics Committee Research UZ/KU Leuven.

I confirm that I have checked the most recent version of the ICF of the study as approved by the EC and that it does not explicitly prohibit the submission of the dataset to EGA.

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Description and source of the dataset