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16th Annual Course on Principles of STD and HIV Research
July 20 - July 30, 2009

Applicants will be notified of their acceptance status after the May 1, 2009 application deadline.

NOTE: - SUBMIT YOUR CV HERE - Click on email address rmohr@u.washington.edu and attach your CV. The CV must be attached in order for this application to be processed.

Online Application

* indicates mandatory field

*First Name:

*Last Name:
 

Email:
 

Phone:

Fax:
 

Organization:
 

*Mailing Address:

*City:

State:

Zip Code:

*Country:
 

Gender:

Female
Male
Other
I choose not to provide this information

 

Ethnicity:

Hispanic or Latino
Not Hispanic or Latino
I choose not to provide this information

 

Race
(choose as many
as apply):

American Indian or Alaska Native
White
Asian
Black or African American
Native Hawaiian or other Pacific Islander
I choose not to provide this information

 
 

*What is your principal occupation type?:

    Other:

 
 

*In what type of organization are your primarily employed?:

    Other:

 

*What percentage of your principal occupation is devoted to STD/HIV (choose ONE):

None
1-25 percent
26-50 percent
51-75 percent
76-99 percent
100 percent
 
Are you taking this course for University of Washington credit?

 
Are you submitting a scholarship application?
 

Please write a paragraph explaining why you need/want a scholarship in the box below:

Please describe how this course is relevant to your work in STD/HIV: