Registration Page - 2008 Summer Program on Meta-analysis: Synthesis and Appraisal of Multiple Sources of Empirical Evidence

19 T.W. Alexander Drive
P.O.Box 14006
Research Triangle Park, NC 27709-4006
Tel: 919.685.9350
Fax: 919.685.9360
[email protected]

Statistical and Applied Mathematical Sciences Institute
19 T. W. Alexander Drive
P.O. Box 14006
Research Triangle Park, NC 27709-4006
Tel: 919.685.9350 FAX: 919.685.9360
[email protected]

SAMSI Summer Program on Meta-analysis: Synthesis and Appraisal of Multiple Sources of Empirical Evidence

June 2-13, 2008

Application/Registration for
Tutorials, Workshop and Working Groups

To apply to attend the workshop or for travel support, or to register if you are an invited participant, please fill out the form below, and then click the SUBMIT APPLICATION/REGISTRATION button. Items in red are required. Following submission, a confirmation of your application or registration will be displayed. (Print a copy for your records.) Applicants will be notified as soon as possible if their application is approved, and should not make travel arrangements until notification is received.

APPLICATION/REGISTRATION DEADLINE: May 23 , 2008

SAMSI Travel Policy

Registration Fees

	Tutorials	Workshop	Working Groups
	June 2-4	June 5-6	June 9-13
Faculty/Professional	$120.00	$80.00	no charge
Student	$60.00	$40.00	no charge

Fees are due upon notification of acceptance of your application. SAMSI accepts check, Visa, or MasterCard.

For Credit Card Payments:

Fill out the payment form (PDF file)
Fax it to (919) 685-9331

For Check Payments:

Fill out the payment form (PDF file)
Mail the form and check (payable to SAMSI) to:

SAMSI
Attn: Meta-Analysis Summer 2008 Registration
PO Box 14006
Research Triangle Park, NC 27709-4006

In order to guarantee proper credit to your registration, SAMSI must receive payment by May 23, 2008

Participant Information

First Name Family Name

Title

Organization

Department

Discipline

Address

City

State (Use NA if not US)

Zip (or Postal) Code

Province

Country Required if not US

Telephone

FAX

E-mail

URL

Interest in the Workshop

Please describe briefly your background, and the topics and research areas listed on the webpage that would be particularly interesting to you, or any other areas that we should be considering.

Events to be Attended

Tutorials (June 2-4, 2008)

Workshop (June 5-6, 2008)

Working Groups (June 9-13, 2008)

Status: Student Faculty/Professional

Poster Presentations

Check here if you wish to present a poster at the June 4 poster session, and if so provide the title.

Poster Title

Poster Session Attendance

I will attend the poster session on June 4.

Request for Financial Support

I wish to apply for financial support. Support levels will be determined by SAMSI. For our records and reports, applicants for support (especially new researchers) are requested to E-mail a brief CV or resume to [email protected]. New researchers and members of under-represented groups are especially encouraged to apply.

Please indicate the resources that you would need in order to be able to participate in the program.

NISS Affiliates and NISS/SAMSI University Affiliates Only

Check this box if you are from a NISS Affiliate and plan to request reimbursement from your NISS/SAMSI Reimbursement Account.

Graduate Students Only

Please check the box below, and in the "special request" block, identify your advisor and dissertation topic.

I am a graduate student.

Others to Contact

Of your colleagues, whom should we contact? We are especially keen to learn of women and members of underrepresented groups that are active or interested in the area; one of SAMSI’s goals is to enhance the participation of such individuals. If you are entering more than one name, please put a comma between them.

Special Requests

If you have special requests (such as dietary restrictions), please enter them below. Other questions should be sent by E-mail to [email protected].

Submission

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