Skip to content
2019 Rally for Medical Research Participant Sign-Up
General Information
View participant guidelines
Registration Deadline: September 4, 2019
1.
Please enter your full name
(Required.)
First Name
Last Name
2.
Email Address
(Required.)
Please provide a contact number in order to reach you while in Washington, DC with any day-of-the-Rally changes.
3.
Affiliated Organization
Affiliated Organization
If staff, please indicate your role/title
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)
5.
Have you participated in a Hill Day before?
(Required.)
Yes
No
Please note that attendance at both the Rally for Medical Research Training and Breakfast is highly recommended, especially for first-time Rally participants.
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)
7.
Are you interested in meeting with your local Congressional offices during the Rally?
Yes
No
