Form 1 NIH OAR NIMH Virtual Workshop Registration form

Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

NIH OAR NIMH Virtual Workshop Registration Form

NIH OAR & NIMH Virtual Workshop Registration (NIMH)

OMB: 0925-0740

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OMB #0925-0740

Exp date 7/31/2022


NIH OAR & NIMH Virtual Workshop

Registration Form


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NIH OAR & NIMH Report Out Session for the HIV-Related Intersectional Stigma Research Advances and Opportunities Virtual Workshop

September 18, 2020 11:30 am – 2:30 pm ET

Virtual

Sponsored by the National Institute of Mental Health (NIMH)


Registration

To register for the workshop on September 18, 2020, please provide the information requested below. You will receive a confirmation e-mail from the Bizzell Group ([email protected]) following your submission of this completed online form.

There is no registration fee and no on-site registration.


Contact Information

denotes required information

First Name :

Last Name :

Street Address:

Suite I Apt I Box City:

State/Province/Region:

Zip/Postal Code:

Country:

Email address :

Organization :

Role : (dropdown options are community, research, private sector, CBO/NGO, government, and other [with a text box])

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAgarwal, Rajni (NIH/NIMH) [E]
File Modified0000-00-00
File Created2022-02-01

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