Please read 2007 TRE Workshop - Details before completing this form.
Please print this page, fill it out (please print neatly or type), and send it to the Poynter Center at the address below. (If you prefer, you can use this PDF version.)
| Name: | |
| Address: | |
| City, state, ZIP: | |
| Institution or organization: | |
| Department or unit: | |
| Telephone number: | |
| FAX number: | |
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| Please indicate any dietary and/or mobility restrictions we should know about: | |
| How would you like your name to appear on your name badge? (e.g., Ken or Kenneth or KD?): | |
Please rank order your preferences (1st, 2nd, 3rd, etc. -- click on headings below for details).
Intensive tracks (you will participate in one Intensive Track that will meet three times):
____ Ethical issues in using human subjects in biomedical research
____ Ethical issues in using human subjects in social, behavioral, and humanistic research
____ Ethical theory
Breakout sessions (you will participate in two Breakout Sessions that will each meet once):
____ Oversight and administration of research
____ Program and curricular development
____ Research with communities
____ Selecting, creating, and using case studies in teaching research ethics
____ Techniques and tactics for teaching research ethics
How did you learn about the workshop? Please check all that apply and fill in "Other" if appropriate.
| ____ A flyer sent via regular post | ____ An announcement sent via e-mail |
| ____ The World Wide Web | ____ A friend or colleague |
| ____ An announcement in a newsletter or journal (title ____________________________________________) | |
| Other _________________________________________________________________________________ | |
Workshop fee. The fee for the 2007 workshop is $700 (U.S.). A $100 deposit is required with registration; the balance of the fee must be received by March 30, 2007. Please see 2007 TRE Workshop - Details for details on the workshop fee, payment options, and our cancellation policy.
| Payment type: ___ Check ___ Purchase order ___ Credit card | Total enclosed: $_________ |
Please submit the completed form and payment via regular mail to Glenda Murray, Poynter Center-TRE, Indiana University, 618 East Third Street, Bloomington IN 47405-3602; FAX to 812-855-3315; or e-mail to glmurray@indiana.edu.