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61778 55th Annual MSBRF - Judge Availability Survey

CONTACT INFORMATION

This survey is intended to gauge your availability for judging of the 55th Annual Midwest Student Biomedical Research Forum.

Abstracts judging will begin in January 2024.

The Forum will be held IN PERSON at the Mike and Josie Harper Center for Student Life and Learning on Saturday, March 2, 2024.
Contact Information
Full Name
(Please list your name and credentials exactly as you want them to appear on all promotional materials.)(Required.)
Cell Number:  (Please include the area code)(Required.)
Email Address:(Required.)
Affiliation:  (Indicate all that apply.)(Required.)
Department Name(Required.)
Department Phone  (Please include the area code)(Required.)
Campus / Zip Code(Required.)
Please provide a brief description of your personal research interests:(Required.)
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