Form 1 NCORP Annual Meeting Registration

OMB No.: 0925-0740

Expiration Date: 7/31/2022

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Registration

Please complete this form to register for the 2020 NCORP Virtual Annual Meeting. An asterisk (*) indicates required information.

Meeting Information

The meeting will run from approximately 12 p.m. to 6:00 p.m. ET on August 31^st and 2:00 p.m. to 5:00 p.m. ET on October 6^th.

We encourage those wishing to participate to register by Friday, August 21, 2020; although meeting registration will remain open through October 1, 2020. There is no fee to attend the 2020 Virtual NCORP Annual meeting. The meeting will be held via WebEx. Registrants will receive the meeting login information prior to the meeting.

There is no limit to the number of representatives from an NCORP to attend. Each NCORP Program (i.e., Community Site, Minority/Underserved Community Site, and Research Base) is encouraged to register all representatives that will attend virtually including PIs, Administrators, Site Investigators, CCDR Leads, and other Operations/Clinical/Research Managers and Staff.

* First Name

First Name is required.

* Last Name

Last Name is required.

* Degree

Degree is required.

TIP: Hold the CTRL/Command key while clicking to select more than one degree

* NCORP Program

NCORP Program is required.

If Other, explain

Explanation of program is required.

* NCORP Role

NCORP Role is required.

If Other, explain

Explanation of role is required.

* Affiliate/Sub-affiliate

Institution/Component is required.

* Email

Email is required. Email format is not correct, please ensure your entry is accurate.

2020 Virtual NCORP Annual Meeting Participation

*Please select the meeting date(s) that you plan to attend. You can locate the agendas for each day on the meeting webpage.

Monday, August 31, 2020 | 12:00 p.m. - 6:00 p.m.

Tuesday, October 6, 2020 | 2:00 p.m. – 5:00 p.m.