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CONCENT FORM

I (Applicant) accept Terms and Conditions below in submitting my application to COCKPI-T ® Funding 2023.

Terms and Conditions for an application to COCKPI-T® Funding

  1. Takeda Pharmaceutical Company Limited (“Takeda”) and its affiliates shall have no obligations, including confidentiality and non-use obligations, on information disclosed or received from an applicant (“Applicant”) in relation to an application to COCKPI-T® Funding (“Information”).

  2. Takeda or its affiliates may use (including maintain, copy/reproduce, disclose or provide to any third parties, disposal, hereinafter collectively “Use”) the Information for COCKPI-T® Funding and shall not Use for any other purposes, without prior written consent from the Applicant.

  3. The Applicant hereby represents and warrants that (i) it has the right and authorization to apply to the COCKPI-T® Funding and to accept the terms and conditions for an application to COCKPI-T® Funding (“Terms and Conditions”), and (ii) Applicant’s disclosure and provisions of the Information to Takeda, and Takeda’s Use of the Information, shall not infringe any intellectual property rights and any other rights of any third parties, including Applicant’s current or former employers, such as universities or any other public research institutes.

  4. The Applicant hereby represents and warrants that, to the Applicant’s knowledge at the time of the Applicant’s disclosure and provision of the Information to Takeda, (i) the Information correctly reflects relevant facts, and (ii) there are no false or error in and to the Information.

  5. The Applicant agrees that (i) Takeda conducts selection of COCKPI-T® Funding, at its sole discretion, and (ii) Takeda will notify the Applicant by e-mail (a) of the result of the first selection until 26 Sep 2023, and (b) of the result of the second selection until 14 Nov 2023.

  6. The Applicant acknowledges and agrees that (i) his or her application to COCKPI-T® Funding will be made at his or her own discretion, and (ii) Takeda shall not be responsible for any damage or disadvantage incurred to the Applicant in relation to the application.

  7. Takeda agrees (i) to comply with relevant laws and regulations regarding protection of personal information and (ii) to use personal information received from the Applicant in relation to the application to COCKPI-T® Funding, such as Applicant’s name and address, solely for COCKPI-T® Funding and collaboration with Takeda in relation thereto.

  8. The Applicant agrees that (i) any and all communication regarding COCKPI-T® Funding shall be made to Takeda’s COCKPI-T® Funding Office ([email protected]) and (ii) unless otherwise designated by Takeda, the Applicant shall not directly contact via Takeda’s other e-mail address, telephone, and personnel.

  9. The Terms and Conditions contain the entire agreement between the Applicant and Takeda with respect to COCKPI-T® Funding, and supersede all prior written or oral agreements and understandings between the Applicant and Takeda thereto. The Terms and Conditions may not be amended, nor binding to the Applicant and Takeda, unless such modifications shall be in writing and signed by Takeda.



  10. I ACCEPT
    I DO NOT ACCEPT