Individuals wishing to analyze CM4FP data and/or compose written materials based on CM4FP data are required to complete this application form. Access to the data is provided through Harvard Dataverse. If you do not already have an account, please create one prior to submitting this form at https://dataverse.harvard.edu/.

Once submitted, this form will be processed by PSI’s Strategy and Insights team. We aim to reply to all requests within 5 business days. Please contact research@psi.org with any questions.

1. First Name *

Last Name *

2. Email *

3. First and Last Name as entered in Harvard Dataverse * Access to the data is provided through Harvard Dataverse. Please provide your Given Name and Family Name associated with your Harvard Dataverse account (as shown under Account Information at top right of screen). If you do not already have an account, please create one at https://dataverse.harvard.edu/ prior to submitting this form.

4. Job Title *

Institutional affiliation (university, organization, etc) *

5. Are you collaborating with others on this project? * YesNo 6. If 'Yes', provide the name(s), email(s), and title/affiliation(s) of the other individuals who will need access to PSI data.

Collaborator 1 - Name

Collaborator 1 - Email

Collaborator 1 - Title/Affiliation

Collaborator 2 - Name

Collaborator 2 - Email

Collaborator 2 - Title/Affiliation

Collaborator 3 - Name

Collaborator 3 - Email

Collaborator 3 - Title/Affiliation

Collaborator 4 - Name

Collaborator 4 - Email

Collaborator 4 - Title/Affiliation

Collaborator 5 - Name

Collaborator 5 - Email

Collaborator 5 - Title/Affiliation

7. Which CM4FP datasets do you require access to? Please choose by Country and Dataset Shape

Kenya – Outlet R1 long CsvStata

Kenya – Outlet R1 Wide CsvStata

Kenya – Outlet R2 long CsvStata

Kenya – Outlet R2 wide CsvStata

Kenya – Outlet R3 long CsvStata

Kenya – Outlet R3 Wide CsvStata

Kenya - Distance and Time R1-R3 CsvStata

Kenya – Household R1 CsvStata

Kenya – Household R2 CsvStata

Kenya – Household R3 CsvStata

Nigeria – Outlet R1 long CsvStata

Nigeria – Outlet R1 wide CsvStata

Nigeria – Outlet R2 long CsvStata

Nigeria – Outlet R2 wide CsvStata

Nigeria – Outlet R3 long CsvStata

Nigeria – Outlet R3 wide CsvStata

Nigeria - Distance and Time R1-R3 CsvStata

Nigeria – Household R1 CsvStata

Nigeria – Household R2 CsvStata

Nigeria – Household R3 CsvStata

Uganda – Outlet R1 long CsvStata

Uganda – Outlet R1 wide CsvStata

Uganda – Outlet R2 long CsvStata

Uganda – Outlet R2 wide CsvStata

Uganda - Distance and Time R1-R2 CsvStata

Uganda – Household R1 CsvStata

Uganda – Household R2 CsvStata

8. How will you use PSI data in your original research project (check all that apply) * Analysis only; not for publicationThesis or dissertationManuscript for peer reviewOther non-peer reviewed written materials for publicationConference presentation

9. Specify the aims and objectives of your proposed research *

10. How will you responsibly store and protect the data (check all that apply)? * Password protected filePassword protected computerSecure network serverOther

If Other, please describe:

11. Does the geographic location where you will store these data (eg. Server location) require GDPR compliance? * YesNo

If the geographic location requires GDPR compliance, please explain how you will ensure compliance

12. Please describe how you will destroy the data one year after receiving it *

Lead Author * Signature and Date, see terms below

Collaborator 1 Signature and Date, see terms below

Collaborator 2 Signature and Date, see terms below

Collaborator 3 Signature and Date, see terms below

Collaborator 4 Signature and Date, see terms below

Collaborator 5 Signature and Date, see terms below

Comments

By typing my name in the box above, I i) acknowledge that I have read, understood, and agreed to abide by the PSI data use terms, including the following:

There will be no attempt to re-identify deidentified data or deidentified specimens under any circumstances. All PSI data sets will be kept confidential.
PSI data will be securely stored and destroyed no more than 1 year following the date of this agreement.
PSI data will only be used for the purposes outlined in this Data Request Form.
Any manuscripts produced using PSI data will be completed and bound by the terms set forth in the PSI authorship agreement. PSI will be given a minimum of 30 days notice of any planned publication submission.
The integrity of the research data will not be compromised through any of the following means: plagiarism, falsification, or fabrication of data.
For any document, publication, poster, or presentation emanating from the research outlined in PSI's Data Request Form or PSI's Authorship Agreement, you agree to prominently and explicitly acknowledge that (i) all data used to prepare the document, publication, poster, or presentation were collected for/by PSI; and (ii) all such data are owned by PSI and are used with the permission of PSI. This acknowledgement will be provided as follows: "Data obtained and analyzed with permission from Population Services International, Evidence Department, Washington, D.C. (www.psi.org/research); all rights reserved by PSI." If instructed by PSI, you agree to acknowledge the donor organization that funded the data collection

and ii) understand that this electronic signature is the equivalent of my handwritten signature.

Full Terms of Use for PSI Data are available here.