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* 1. Registrant Name

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* 2. Home Mailing Address (to which award cheques, if applicable, should be sent)

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* 3. Contact Info

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* 4. University/School you are representing

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* 5. Select the most relevant CIHR Institute to your research

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* 6. Select the second most relevant CIHR Institute to your research (if relevant)

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* 7. Select the third most relevant CIHR Institute to your research (if relevant)

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* 8. Program

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* 9. Are you registered in the Canadian Society for Epidemiology and Biostatistics National Student Conference?

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* 10. Will you be registering in the CNMSRS as well? http://umanitoba.ca/outreach/conferences/cnmsrs/index.html

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* 11. Nominator

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* 12. Abstract

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* 13. Please paste your abstract below. Maximum 350 words. Use the sample abstract format found on the FAQ page of our website.

Please also email a formatted PDF copy of your abstract to srforum@umanitoba.ca

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* 14. All abstracts are published in the proceedings of the event and photographs of winners will appear on our webpage.

Please click the button below to submit your registration.

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