PASCAR Clinical Research Training Task Force Short Course Application 2023

PASCAR Clinical Research Training Task Force Short Course Application 2023

April - September 2023 | Virtual Training | Application deadline: 17 April 2023
This course is intended for cardiologists, specialist physicians, scientists or cardiology fellows with a day-to-day interest in cardiovascular research.
Consent: I understand the purpose for disclosing this personal information. Collection of this information complies with The Protection of Personal Information Act 4 of 2013 (POPI), South Africa. If you have any questions about the Privacy Policy contact the society office on info@pascar.org*

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Please note that consent is needed to apply for this course.
Confirmation of Specialty*

I confirm that I am a registered cardiologist, specialist physician, scientist or cardiology fellow. I will attend this course in my professional capacity. All provided information is true and correct.I am not a cardiologist, specialist physician, scientist or cardiology fellow.
Specialty*

CardiologistSpecialist PhysicianCardiology FellowScientistOther
Registration Fee Confirmation*

I confirm that I am able to fund the registration fee of USD150 (EFT payment to PASCAR)
Applicant Information*

TitleFirst NameLast Name
Email Address*
example@example.com
Mobile Number*

Area CodePhone Number
Gender*

MaleFemale
Age*

Younger than 35 years35 - 45 years46 - 55 yearsOlders than 55 years
Hospital Affiliation*
City *
Country*
Language (day-to-day in clinic) *
Medical English Proficiency:*

PoorGoodExcellent
Motivational Paragraph (Including what do you expect to gain from attending the PASCAR Clinical Research Training Task Force Short Course, current, previous and/or possible cardiovascular research)*

0/100
C.V. and relevant certificates*

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Letters of recommendation from National Cardiac Society or Head of Department (or line manager)*

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PASCAR Clinical Research Training Short Course is supported and facilitated by:
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