Thank you for your interest in participating in Dr. Denice Cora-Bramble's visiting professorship at CCHMC on April 29, 2014. Please complete the following registration form by Friday, April 11, 2014 to confirm your attendance.

Don't hesitate to contact the OFD at faculty-development@cchmc.org with any questions you might have.

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* 1. What is your name?

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* 2. Email address:

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* 3. At which location do you work?

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* 4. Which session(s) are you planning to attend?

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