Exit this survey 2016 CIHR National Competition Application Form Question Title * 1. Registrant Name First Name Last Name Question Title * 2. Home Mailing Address (to which award cheques, if applicable, should be sent) Street Address City Province Postal Code Question Title * 3. Contact Info Home Phone Cell Phone Email Address Email Address (additional) Question Title * 4. University/School you are representing Question Title * 5. Select the most relevant CIHR Institute to your research Aboriginal People's Health Aging Cancer Research Circulatory and Respiratory Health Gender and Health Genetics Health Services and Policy Research Human Development, Child and Youth Health Infection and Immunity Musculoskeletal Health and Arthritis Neurosciences, Mental Health and Addiction Nutrition, Metabolism and Diabetes Population and Public Health Question Title * 6. Select the second most relevant CIHR Institute to your research (if relevant) Aboriginal People's Health Aging Cancer Research Circulatory and Respiratory Health Gender and Health Genetics Health Services and Policy Research Human Development, Child and Youth Health Infection and Immunity Musculoskeletal Health and Arthritis Neurosciences, Mental Health and Addiction Nutrition, Metabolism and Diabetes Population and Public Health Question Title * 7. Select the third most relevant CIHR Institute to your research (if relevant) Aboriginal People's Health Aging Cancer Research Circulatory and Respiratory Health Gender and Health Genetics Health Services and Policy Research Human Development, Child and Youth Health Infection and Immunity Musculoskeletal Health and Arthritis Neurosciences, Mental Health and Addiction Nutrition, Metabolism and Diabetes Population and Public Health Question Title * 8. Program PhD MD/PhD Question Title * 9. Are you registered in the Canadian Society for Epidemiology and Biostatistics National Student Conference? Yes No Question Title * 10. Will you be registering in the CNMSRS as well? http://umanitoba.ca/outreach/conferences/cnmsrs/index.html Yes No Question Title * 11. Nominator Name Email Question Title * 12. Abstract Title Author(s) Institution(s) Question Title * 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 Question Title * 14. All abstracts are published in the proceedings of the event and photographs of winners will appear on our webpage. I agree Please click the button below to submit your registration. Submit Registration