REGISTRATION
eBridge - Walk-in Sessions for PRO SmartForm Conversion from V1 - V3 All walk-in sessions will take place in the MCW Computer Lab, Medical Education Building, MCW |
| First Name * | * Denotes a Required Field |
| Last Name * | |
| Department * | | If Other, please enter a department description | |
| Job Title * | i.e. Research Technologist II |
| Phone # * (xxx-xxx-xxxx) | | Parking Needed? | Yes No |
| Email Address * | | Special Needs? | Yes No |
| Are you a Principal Investigator? | Yes No | If not, who is the Principal Investigator of your study?
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| Please select your choice of available dates | |
| Please select a second date in case the first date is cancelled due to minimum class size requirement not met. | |