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Innovate4AMR 2019 Sign-Up
If you are interested in participating in the second Innovate4AMR competition, please fill out the form below. This list will primarily be used to contact interested individuals with more information.
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Name
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Your answer
Email
*
Your answer
Name of Institution
*
Your answer
Affiliation with Institution
Student
Faculty
Staff
Administrator
Other:
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Location of Institution
*
Your answer
Country of Residence/Citizenship (Why are we asking this? visit
http://innovate4amr.org/rules
)
*
Your answer
[IF STUDENT] Current Level of Educational Pursuit (ex: bachelor's, professional degree, master's degree, graduate degree, etc.)
Your answer
How did you hear about Innovate4AMR?
*
Email
Innovate4AMR Website
Flyer
Facebook
Twitter or other social media
Mentor/Professor
Professional student group or professional organization
Newsletter or listserv
Other:
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