2019 Rally for Medical Research Participant Sign-Up

General Information

View participant guidelines
Registration Deadline: September 4, 2019

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1. Please enter your full name

First Name

Last Name

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2. Email Address

Please provide a contact number in order to reach you while in Washington, DC with any day-of-the-Rally changes.

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3. Affiliated Organization

Affiliated Organization

If staff, please indicate your role/title

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4. How would you describe yourself?

Government Relations professional

Affiliated Organization staff

Patient advocate

Scientist

Student

Physician or healthcare professional

Industry representative

Survivor

Other (please specify)

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5. Have you participated in a Hill Day before?

Yes

Please note that attendance at both the Rally for Medical Research Training and Breakfast is highly recommended, especially for first-time Rally participants.

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6. What events will you participate in during the 2019 Rally for Medical Research?

Rally for Medical Research Training (2:00 pm - 5:00 pm Wednesday September 18)

Reception to Celebrate Medical Research (6:00 pm - 8:00 pm Wednesday, September 18)

Rally for Medical Research Breakfast (7:30 am - 9:30 am Thursday, September 19)

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7. Are you interested in meeting with your local Congressional offices during the Rally?

Yes