2002 Summer Public Health Research Institute and Videoconference on
Minority Health

Continuing education credits

Find a Videoconference site in your state

To register to receive 1.3 Continuing Education Credits, please provide the information below and then click the REGISTER NOW button. Items marked with an * are required.

*Name

       
       *First             Middle                   *Last
*Participant Code
(Please use a total of 4 digits, e.g., last 4 digits of home or other phone number.)

Agency

Type of Agency
Local Health Dept. Other Government/Municipal Agency
Managed Care Hospital/Medical Practice/Nursing Home
Educational/Research/AHEC Community/Consumer/Advocacy/
Philanthropic
Business/Commercial Professional Society

*Address (line 1)

Address (line 2)

*City

 *State  *Zip

County

*E-mail Address

Job Title/Position

*Occupation

*Daytime Phone

Area code + number

Fax

Area code + number

Evening phone

Area code + number

To Register:

  • Click the REGISTER NOW button (see below), OR

  • Phone the registration information to 919-843-6934, OR

  • E-mail the registration information to Minority_Health@unc.edu, OR

  • Print this form to and fax it to 919-966-0458, OR

  • Mail your completed registration form to:

    Minority Health Project
    Department of Maternal and Child Health School of Public Health
    University of North Carolina at Chapel Hill Rosenau, CB# 7445
    Chapel Hill, NC 27599-7445

You will receive email or written confirmation of your registration. If you have not received a confirmation within one week of submission, please call at 919-843-6934 to check on the status of your registration.

Admission to School of Public Health programs is without regard to race, sex, national origin, color, religion, handicap, age or veteran's status.

If you have any questions about this conference or registration, please call at 919-843-6934 or send email to Minority_Health@unc.edu.


         

05/23/02rajs