Course in Scientific Management & Leadership
Registration For Course Alumni
Date: Friday, March 26, 2010
Herberman Conference Center
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First Name
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Last Name
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Primary School
Select one from list:
Dental Medicine
Health & Rehab. Sciences
Medicine
Nursing
Pharmacy
Public Health
Other School
Does Not Apply
If Other,
School Name:
Department
Division
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Primary Position Title
Select one from list:
Faculty:Professor
Faculty:Associate Professor
Faculty:Research Associate Professor
Faculty:Assistant Professor
Faculty:Research Assistant Professor
Faculty:Instructor
Faculty:Visiting
Faculty:Other
Research Associate
Fellow:Clinical
Fellow:Postdoctoral
Fellow:Other
Resident
Staff
Student:MD/PhD
Student:Graduate
Student:Medical
Student:Undergraduate
Student:Other
Other
If Other,
Title:
Phone
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Email Address
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In what year did you attend the course?
2006
2007
2008
2009
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Select all that apply:
I will attend the Alumni Delegation Session: March 26, 2010 1:30-3 PM
I will attend: Becoming a More Productive Writer, March 26, 2010 3:15-4:30 PM
I will attend the closing reception: March 26, 2010 5:00-6:00 PM
Questions?
Contact the Office of Academic Career Development
412-648-8486 or oacd@hs.pitt.edu
Print screen for your records before submitting.
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Indicates Response Required