Industry Advisory Council for ENRICHMENT in Silico Clinical Trial Project
Thank you for your interest in joining the Industry Advisory Council (IAC). Please fill out the application below so that we have the opportunity to bring together a diverse group.
Name
*
Prefix
First Name
Last Name
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Email
*
example@example.com
Job Title
*
Company/Organization
*
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you heard about the ENRICHMENT in Silico Clinical Trial project prior to this?
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Yes
No
What is your role in your organization?
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Technical
Regulatory
Quality Compliance
Other
Are you employed by a medical device company that distributes class 2 or 3 medical devices (of any nature) directly to the market?
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Yes
No
Do you have experience conducting (directly or indirectly) clinical trials?
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Yes
No
What do you hope to gain by joining the IAC and what can you contribute?
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Please provide your biography either in the text box or by uploading a file below.
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If you are uploading a file below, enter "bio attached" here.
Upload biography here.
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