Google NIH STRIDES Customer Agreement Request Form

Welcome to the NIH STRIDES Initiative!

Fill out the form below in regards to your billing account information.

First Name Required

Last Name Required

Email Required

Phone Required

Title Required

Institution Required

Award/Project/Application Id Required

Name of NIH Program Officer Required

Email of NIH Program Officer Required

Name of Billing Account Administrator Required

Email of Billing Account Administrator (Google email only) Required

Phone of Billing Account Administrator Required

Please confirm that you have contacted or will contact your Program Officer in regards to this request Required

Do you have interest in training? Required

Yes

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