Symposium on Racial/Ethnic Health Disparities Research in the US
Harvard University
ATTENTION: DUE TO OVERWHELMING RESPONSE ANY REGISTRATION RECEIVED AFTER APRIL 1, 2003 WILL BE PUT ON A WAITING LIST. AS SEATS BECOME AVAILABLE WE WILL TRY TO ACCOMODATE MORE REGISTRANTS. OTHERWISE A LIST OF REGISTRANTS ON THIS WAITING LIST WILL BE AVAILABLE AT THE SYMPOSIUM
Please provide the following information to register.
School
Graduate School of Arts and Sciences
Graduate School of Education
Harvard Business School
Harvard Dental School
Harvard Law School
Harvard Medical School
Harvard School of Public Health
Divinity School
Radcliffe Institute
Kennedy School of Government
Harvard College
Other,please specify
What is your primary affiliation?
1) Faculty member
2) Administration
3) Master's program
4) Ph.D. program
5) Post-doctoral program
6) Medical/Dental program
7) Visiting Fellow
8) Undergraduate
9) Other
Title
1) Mr.
2) Dr.
3) Ms.
4) Mrs.
First Name
Last Name
Address 1
Address 2
City
State
Zip
Phone
Email Address
What is your preferred method of contact?
1) Phone
2) Email
3) Mail
Please indicate your research interests in health disparities.
Would you be interested in connecting with others with similar interests?
Yes
No
If you answer "yes" to the above question your name will be added to a directory to be distributed on April 11, 2003.
Your registration will be confirmed as seats become available. You will not receive an immediate confirmation of your registration. When you hit "submit" you will be redirected to the Health Policy website.
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