Application

Welcome to the application for the Principles and Practice of Clinical Research course. Only submit this form if you want to register for the course.

If you would like more information before applying, or have questions about the application, please contact us. Please submit your application as soon as possible, as registration is limited. All fields marked with an asterisk are required.

Personal information

First name *

Last name *

Street address *

City *

Country *

Email address *

Language proficiency

What is your native language? *

If you are a native English speaker, mark not applicable for the questions below.

English reading proficiency *

High Medium Low Not applicable

English speaking proficiency *

High Medium Low Not applicable

English writing proficiency *

High Medium Low Not applicable

Professional and academic information

Highest degree, for example MD, PhD or PT *

University of highest degree *

Current position *

Specialty *

Computer skills and learning style

Please rate your level of computer expertise *

No experience Novice Intermediate Expert

The program also collects information about your learning style and time management, so that we can understand how you would adapt to a distance learning program. These answers do not influence acceptance into the program.

Documents

Please prepare the following documents to upload with the application: a curriculum vitae in English, a letter of intent of no more than one page, one recommendation letter, and a professional photograph that clearly shows the face.

Curriculum vitae *

Letter of intent *

By submitting this form I confirm that I have read the course student evaluation.