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Registration for the November 28, 2016 Team Launch Master Class Seminar with Dr. Laura Petersen
Please complete the brief form below to indicate your interest in the third seminar and to receive reminders and updates.
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1.
First Name:
(Required.)
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2.
Last Name:
(Required.)
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3.
Email Address:
(Required.)
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4.
BCM ID Number
(Required.)
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5.
In which Baylor entity are you enrolled or employed (primary)?
(Required.)
School of Medicine/Clinical department
Graduate School of Biomedical Sciences/Basic sciences dept.
School of Allied Health Sciences
National School of Tropical Medicine
Academic, healthcare or research center
Harris Health System
Baylor/St. Luke's Healthcare System
Other (please specify)
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6.
What is your role?
(Required.)
Full time faculty member
Part time or adjunct faculty member
Student in a degree program
Clinical fellow
Postdoctoral fellow
Resident
Administrator or staff member