Human Research Protection Program

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Registration

Human Subject Research Core Education: Boot Camp

 Friday, June 6, 2014

Location:  MFRC 3075                        Time:  8:00 a.m. to 4:00 p.m.

Instructions:  1.  Fill out electronic registration (required).  2.  Select payment type.  If a check will be used, send check made payable to MCW with a note or copy of the electronic registration to Office of Research, MFRC.  When paying by transfer of funds, a number must be provided. More information below.

*Required Field  
*Last Name  
*First Name  
Credentials  
 *E-mail  
 *Institution  
 *Department  
 *Position Title  
 * How long have you been on a human research team?
* What is your area of research? (genetic, observational, drug, device, educational, etc)

 Special Needs?  (dietary, etc.) 

 Parking Needed?Yes         No

 *Phone Number (daytime)

 

*Payment Type (Pre-payment required)

*Internal Transfer of Funds (MCW Only):

$75.00 to Office of Research (credit)
Account #45002-471400-103-3304426

  

Account to be debited

(Cost Center, Natural Account, Fund #or Grant #, Activity Code)

A number MUST be provided  (5, 6, 3, 3 digits respectively)(Grant cannot be NIH)

 *Name of Department Administrator or Business Manager

 

 *email for Department Administrator or Business Manager

 

 

For Internal Transfer of Funds:  The Department Administrator or Business Manager will be e-mailed and asked to confirm that payment for this course has been approved. Internal transfers occur from MCW departments.  Remember, a NUMBER MUST be provided as only MCW departments can initiate an internal transfer of funds.

Check payment:  Accepted only from outside MCW sources (includes a personal check).  Registration will be complete upon receipt of check.  Send attention to Office of Research, MFRC.

 

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Page Updated 04/30/2014