Health Research Under the Microscope

							                    Health Research Under the Microscope
                                    May 3rd, 2012
                McMaster University Student Learning Centre, CIBC Hall
                         RSVP via e-mail to: hrum@hhsc.ca or fax 905.577.8378
                                All fields must be complete on this form.
PARTICIPATING HIGH SCHOOL NAME:
               Street:                                              Phone:
Address
               City:                              PC:               Fax:
CHAPERONE INFORMATION:
Chaperone Name:
Contact Name (if different from Chaperone):
Phone Number:
Email Address:
STUDENT INFORMATION:
Number of Student Attendees (between 1-4):
   Student Names:                       First                                  Last
                    (1)
                    (2)
                    (3)
                    (4)
 *NOTE: If student names are still to be determined, you will be contacted in January 2011 for the
                        names of attendees, if not provided with this RSVP.

Waiting List for Additional Student Request (optional) (between 1-4):
  Student Names:                       First                                    Last
                    (1)
                    (2)
                    (3)
                    (4)
     *NOTE: Names identified here will be placed on a waiting list. These names will only be
                     enrolled/confirmed to attend, based on availability only .

      Health Research Under the Microscope will provide a continental breakfast, buffet lunch,
                     information materials and parking passes for attendees.
                       Confirmation notice to follow closer to the event date.
                Please note: A Chaperone must attend with participating students.


I:\Research and Trust\PROGRAMS