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REGISTRATION

Please complete the following registration for the "Grants, Golf, Grand Rounds and Grandkids: Charting Your Course for Retirement" workshop on Thursday, February 11 from 3-5 p.m., N-225, Parnassus Campus.

1. First Name:

First Name:

2. Last Name:

Last Name:

3. Email Address:

Email Address:

4. School:

School: School of Dentistry

School of Medicine

School of Nursing

School of Pharmacy

5. Department/Division:

Department/Division:

6. Academic Position:

Academic Position: Instructor

Assistant Professor

Associate Professor

Professor

Other (please specify)