PED 5902 Student Application

Please complete the following form by the listed due date (available on our website). Late submissions will only be considered if there are still seats available.

Any questions can be directed to PedResearchEducation@hsc.utah.edu.

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* 1. Which semester you are applying for?

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* 2. Basic Contact & Education Information

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* 3. I have taken (or am currently enrolled in) PED 5900.

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* 4. I have taken (or am currently enrolled in) PED 5901.

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* 5. Do you plan on completing the full Pediatric Clinical Research Minor?

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* 6. I am available to attend mandatory orientation (always the Friday BEFORE classes start).

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* 7. I understand that there are requirements to complete BEFORE orientation day in order to participate in this class.

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* 8. In a paragraph, explain why you are interested in this class?

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* 10. Comments

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