Registration Form

1. Contact Information. *This question is required.

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required. This question requires a valid email address.

Occupational Status *This question is required.

Please enter an 'other' value for this selection.

Primary Institutional Affiliation *This question is required.

Department, Unit or Program

Webpage (Institutional or Laboratory), if available

Please tell us about your research, field(s) of study or area(s) of expertise.

2. Discipline(s): *This question is required.

3. What data type(s) do you work with?

E.g. administrative data, electronic medical records, education, transportation, physical environment, built environment, social data, justice and corrections, public health surveillance data, survey data, other

*This question is required.

4. List keywords that relate to your research and/or area(s) of expertise: *This question is required.

General Information

5. List any food food preferences and/or allergies.

6. A meeting e-booklet containing registration information provided by Workshop participants will be made publicly available on the website of the Dalla Lana School of Public Health. If you do not wish your information to be included in the online e-booklet, please check the box below.

E-booklet opt out

Registration Form

Page One