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					Clinical Research Development Office Seminar Series
Registration Form 2011
TAX INVOICE: ABN 21 006 566 972

Clinical Research Development Office Seminars will run for 2.5hours.

Please tick the Seminars you wish to Attend:
Seminar                                              Date

GCP & Clinical Research Basics                       __ __ / __ __ __

The Complete Guide to Informed Consent               __ __ / __ __ __

Working with the campus HREC                         __ __ / __ __ __

How to Run a Clinical Research Project               __ __ / __ __ __

Time and Team Management                             __ __ / __ __ __

Financials of Clinical Research                      __ __ / __ __ __


NAME:

POSITION:

JOB TYPE: (mark 1 only)                                Clinical                       Nursing
                                                       Allied Health                  Social Science
                                                       Lab Science                    Other:

STUDENT TYPE: (mark 1 only)                            Master of Medicine             MD
                                                       AMS                            PhD
                                                       Honors                         Other:

DEPARTMENT:

ORGANISATION:

STREET:

SUBURB:                                                                         POSTCODE:

PHONE NUMBER: (work)                                                            (home/mobile)

EMAIL ADDRESS:

COST: Course is free for RCH, MCRI and UMDP staff.
Internal participants:                                    free
External participants: (inclusive of GST)                 $50 per seminar

Payment by cheque:
Please send a cheque, payable to Murdoch Childrens Research Institute, with this registration form to:
Clinical Research Development Office (CRDO), Murdoch Childrens Research Institute, Royal Childrens Hospital,
Parkville Vic 3052

Payment by credit card:
Card Type:
Holder:
Card Number:
Amex Security Code:
Expiry Date:
Amount:


Enquiries to CRDO Office - Phone: 9345 6362 or 9345 4112: Fax: 9345 6000: Email: crdo.info@mcri.edu.au

				
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