clinical research events registration

Clinical Research Events Registration Form

Please fill up the form for the clinical research events registration.

Personal Information :-

Degree (required)

Member (required)
Please check whether your organization is ISCR AMO (Corporate) member via link - https://www.iscr.org/clinical-research-corporate-members. Even if you are not ISCR member but your organization is ISCR AMO (Corporate) member, you are considered as ISCR member and ISCR Membership fees will apply to you.

Please specify for others

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Date Of Birth (required)

Email (required)

Alternate Email

Phone

Mobile (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Gender (required)

Office Information :-

Official Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Name of your Institution/Company/Organization (required)

Nature of Institution/Company/Organization (required)

Current Job Position (required)

Country where your Institution,Company or Organization is located (required)

Other Information

Remarks

Personal Information :-

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Gender (required)

Degree (required)

MCI Registration Number for CME Credits (required)

Specialisation, Department (required)

Email (required)

Alternate Email

Phone

Mobile Number (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Current Institution (Medical College/Hospital) Name (required)

Current Designation (required)

Other Information (required)

Institution for MBBS (required)

Institution for MD/MS and/or Post-graduate diploma (required)

Institution for any other degree/specialization (DM/MCh or PhD) or certification (required)

Number of years since highest specialisation/degree (required)

Have you undergone any research training

Duration (required)

Topics covered (max 6) (required)

Institution (required)

Year (required)

Publications (required)

Total papers (required)

Total Original Articles (required)

Total Other Publications (required)

Total As First Author (required)

Total As Co-Author (required)

For your top 5 papers mention journal name/ year and area (topic) (required)

Expectations from this course (Please write up to 3 points; be specific and mention topics you would like to learn; avoid general statements such as, I want to be a better researcher etc.)

Remarks

Please register by completing the below form and making the on-line payment. By completing the registration form, you agree that these details will be shared with ISCR and its associated partner for the purpose of CRC Certification Exam.

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Email ID (required)

Mobile Number (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Role (required)

Organization Name (required)

Previous Experience (required)

Remarks

Course Fees inclusive of F2F workshop and final certification exam: Fifteen Thousand Only (15000 INR)

The above fees excludes the travel and accommodation charges for the F2F workshop. Individual participants should arrange for the same.

Training course details and access will be provided to you via email, once the payment registration is completed.

September to December 2019 - ISCR CRC Certification Program 2019

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Email ID (required)

Mobile Number (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Role (required)

Organization Name (required)

Previous Experience (required)

Remarks

Course Fees inclusive of F2F workshop and final certification exam: Fifteen Thousand Only (15000 INR)

The above fees excludes the travel and accommodation charges for the F2F workshop. Individual participants should arrange for the same.

Training course details and access will be provided to you via email, once the payment registration is completed.

20th Dec 2019 - New Regulations to Further Strengthen Clinical Research in India

Personal Information :-

Degree (required)

Please specify for others

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Date Of Birth (required)

Email (required)

Alternate Email

Phone

Mobile (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Gender (required)

Office Information :-

Official Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Name of your Institution/Company/Organization (required)

Nature of Institution/Company/Organization (required)

Current Job Position (required)

Country where your Institution,Company or Organization is located (required)

Other Information

Remarks

10th & 11th December 2019 – Workshop on Clinical Research Methods for Early Career Academic Medical Researchers – Assam

Personal Information :-

Salutation (required)

First Name (required)

Middle Name

Last Name (required)

Gender (required)

Degree (required)

MCI Registration Number for CME Credits (required)

Specialisation, Department (required)

Email (required)

Alternate Email

Phone

Mobile Number (required)

Correspondance Address (required)

Country (required)

State (required)

City (required)

Pin Code (required)

Current Institution (Medical College/Hospital) Name (required)

Current Designation (required)

Other Information (required)

Institution for MBBS (required)

Institution for MD/MS and/or Post-graduate diploma (required)

Institution for any other degree/specialization (DM/MCh or PhD) or certification (required)

Number of years since highest specialisation/degree (required)

Have you undergone any research training

Duration (required)

Topics covered (max 6) (required)

Institution (required)

Year (required)

Publications (required)

Total papers (required)

Total Original Articles (required)

Total Other Publications (required)

Total As First Author (required)

Total As Co-Author (required)

For your top 5 papers mention journal name/ year and area (topic) (required)

Expectations from this course (Please write up to 3 points; be specific and mention topics you would like to learn; avoid general statements such as, I want to be a better researcher etc.)

Remarks