CFAR/TRAC K Club Participant Request Form

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1. Name

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2. Email

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3. Topic of research plan

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4. Mentor Name

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5. Where are you currently in the process of developing your research plan?

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6. Preferred meeting location

In-person

Virtual

Hybrid

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7. My proposal is a:

New Submission

Resubmission

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8. Goal submission date

Date / Time

Date