Not Attending PURE Lisbon?
Please let us know your name and contact information. Thank you.
First Name
*
Middle Name
Last Name
*
Study Position Title
*
Please Select
National Leader
Principal Investigator
Co-Investigator
Project Manager
Site Coordinator
Adjudication
Project Office
PURE MIND
Research Fellow
PHRI Statistics
Other
If you selected Other, please specify
Institution
*
Centre #
*
Argentina - 76
Bangladesh - 90
Brazil - 45-53
Canada - Hamilton - 70
Canada - Vancouver - 71
Canada - Quebec - 72
Canada - Ottawa - 73
CESCAS - Argentina - 77
CESCAS - Chile - 78
CESCAS - Uruguay - 79
Chile - 63
China - Yunnan - 8-20
Colombia - 26
Ecuador - 25
India - Bangalore - 1
India - Chennai - 2
India - Jaipur - 3
India - Trivandrum - 5
India - Chandigarh - 6
Iran - 67
Kazakhstan - 61-62
Kyrgyzstan - 27-30
Malaysia - UiTM - 85
Malaysia - UKM - 86
Poland - Wroclaw - 80
Poland - Warsaw (PONS) - 81
Pakistan - 95
Palestine - 66
Peru - 64
Philippines - 87
Russia - Kemerovo - 54
Russia - - Novogord - 55
Saudi Arabia - Riyadh - 68
Saudi Arabia - Jeddah - 69
South Africa - Potchefstroom - 21
South Africa - Capetown - 22
Sweden - 57
Tanzania - 23
Turkey - 93
UAE - 31-33
Zimbabwe - 40
Project Office - 88
Email
*
Reason for Not Attending
Submit
Should be Empty: