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CFAR Mentor-the-Mentor Training Program Registration
Please complete the following to register for the January 15 & January 22, 2020 training session. The session will be facilitated by Drs. Susan Cu-Uvin and Karen Tashima
First Name
*
Last name
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Email Address
*
Academic Rank
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Professor
Associate Professor
Assistant Professor
Instructor
Investigator
Other:
Other:
Primary Affiliation
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Boston Medical Center
Boston University
Brown University
The Miriam Hospital
Rhode Island Hospital
Other:
Department
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Years of mentoring experience
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Total number of mentees (past and present)
*
Please provide a brief description of your experience as a research mentor?
*
A light dinner will be provided, please note any dietary restrictions.