Pilot Training for Patient Research Partners Yes, I am interested in participating in the pilot training for Patient Research Partners. The pilot will be held in Brussels on Thursday 7th and Friday 8th of October 2010 in the Sheraton Brussels Airport Hotel. The two-day training will start at 13.00h on day 1 and will end at 16.00h on day 2. Your availability on these days is obligatory. Yes, I am available to participate in the pilot training for Patient Research Partners. First name: Family name: E-mail address: Phone number: Country: Organisation: Function in organisation (if applicable): My rheumatic condition: Diagnosed in (year): Your current age: Knowledge of English: Basic Good Native language Background in medical/research area: Yes No If YES, please explain: Experience in participating as a patient in research: Yes No If YES, please explain: Can you briefly describe why you want to participate in this PARE pilot project? What are your expectations of this course? Are you available and willing to join an international research team and to travel abroad? Thank you for filling in this form. Please send back to the PARE Secretariat, at email@example.com, by 1st of June 2010 at the latest.