Registration Form ' Global CBPR Forum Workshop: Taking Off

OMB Control Number: 0690-0038

Expiration Date: 07/31/2026

Registration Form | Global CBPR Forum Workshop: Taking Off

Thank you for registering your attendance for the upcoming Global CBPR Forum Workshop: Taking Off, held in Japan on May 15-17, 2024. (* denotes a required field)

1. Name *

2. Email *

3. Institution/Organization *

4. Country/Location

5. Job Title *

6. Will you be attending the in-person workshop? *

7. Is there anyone else you would like us to extend the invitation to?

8. Please include their name, organization, title and email.

9. Is there anything else you would like us to know?

Your privacy is important to us. By submitting this form, you will be added to the Global CBPR Forum mailing list to receive updates on upcoming Global CBPR Forum events and news. In addition, this information will assist in creating networking opportunities within the Global CBPR Forum community. We intend to retain this information to provide information to participants about upcoming Global CBPR Forum workshops and relevant news. Your contact information, including first name, last name, job title, employer name, and work email may be shared with other Global CBPR Forum Workshop participants. To OPT OUT at any time, please check the box below. 

Public Burden Statement

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The approved OMB Control Number for this information collection is 0690-0038. Without this approval, we could not conduct this information collection. Public reporting for this information collection is estimated to be approximately 1 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. All responses to this information collection are voluntary. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the International Trade Administration Paperwork Reduction Act Program: [email protected] or to Katelynn Byers, ITA PRA Officer: [email protected].