Application - Asilomar for the Brain and Mind Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Affiliation * Title * Briefly describe your current role, expertise, and how it relates to neuroscience, neurotechnology, ethics, or governance. * In your opinion, what are the most pressing ethical questions facing the neuroscience and neurotech industries today? * What principles or frameworks do you believe are essential to ensure that innovations in neuroscience benefit humanity? * If selected, how do you envision contributing to the discussions and outcomes of this gathering? * If someone from the BrainMind ecosystem referred you, please share their name here: Thank you!