PPCR 2017 July Workshops
Welcome the Principles and Practice of Clinical Research 2017 July Workshops application. Only submit this form if you want to apply for the July 2017 workshops held in Boston, MA. If you would like more information before applying or have questions about this application, please contact us at coordinator@ppcr.org. The deadline to register is Monday, July 17, 2017.
*Please complete all fields using standard format of capital letters at the beginning of words and lower case for remaining
Personal Information
First Name (*)
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Middle Name
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Last Name (*)
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Full name as it appears on your passport
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Preferred First Name (*)
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Country of Citizenship (*)
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Street Address (max. 60 characters) (*)
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City (*)
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Country
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State
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Zip Code
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Phone Number (Numbers only, no symbols please) (*)
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Email Address (*)
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Re-enter your email address (*)
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What is your date of birth (DD-MMM-YYYY)
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Highest Degree (*)
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University of Highest Degree (*)
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Year of Graduation (*)
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Current Position (*)
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Current Institution (*)
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Specialty (*)
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What year did you take PPCR? (*)
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Tuition for PPCR 2017 Workshops: PPCR Participants, TA, Alumni - $750 Non-PPCR Participants - $1,500
Select each workshop you are applying for. (*)


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Substitutions may be made without additional charge. All requests for substitutions or cancellations must be made in writing. Cancellations on or before Monday, June 5, 2017 will be issued a refund less a $150 administrative fee per person. Cancellations received between Tuesday, June 6, 2017 and Monday, July 3, 2017 will be issued a refund of 50%. After Monday, July 3, 2017, no refund will be issued. There will be no exceptions to this policy.

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