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Brown Pfizer Master of Arts Program - Course Enrollment Form
Please use this form to enroll in a course for the Brown / Pfizer Graduate Program. All courses are held virtually (via Pfizer Web-EX).. Students must be Pfizer employees. PLEASE NOTE - this form is only to request registration for the class. If you are interested in applying to the Graduate School for admission to the Masters program, please contact Tracey_Cronin@Brown.edu.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
What is your e-mail address?
*
Your answer
What is your Phone #?
Please list the # we can use to contact you about any questions on your application during the working day
Your answer
Gender
*
Male
Female
Required
Please indicate the course in which you intend to enroll
*
Courses are offered on the Pfizer Campus via Web-EX
Spring 2024: "Principles of Immunology" BIOL 2530
Other:
Have you previously taken a Brown / Pfizer Program in Biology course?
Yes
No
Please indicate your employee "location". Although classes are held virtually, your geographic locaton may help with logistics.
Your location will help us to set up necessary logistics. If "other", please explain
New London, CT employee -- Attending Virtually
Cambridge, MA Pfizer employee - attending virtually
Other:
Clear selection
Home Address (Street) (ONLY needed if this is your first course)
If you have previously enrolled in a Brown Pfizer course AND there are no changes in your home address, you do NOT have to fill out your home address info.
Your answer
Address Line 2
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Country of Citizenship
*
Your answer
Department and Position at Pfizer
Your answer
If this if your first course at Brown, please complete the information below.
If you have already taken a course at Brown, YOU DO NOT NEED TO COMPLETE THIS INFORMATION.
What is your birth date?
*
Month-Day-Year
MM
/
DD
/
YYYY
How long have you been employed at Pfizer?
Your answer
Information about your Bachelor's Degree
Please list the University / College, Degree achieved , Year of Degree
Your answer
Please submit your statement of intent.
The statement of intent is not a formal component of the degree application but a way for Brown to get a sense of the needs of the Pfizer community. Please include your reasons for taking the class and whether you intend to complete a degree. This statement does not need to be extensive.
Your answer
A copy of your responses will be emailed to the address you provided.
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