MSRD 2019 Judges Availability Form

Office of Student Research655 West Baltimore StreetBressler Research Building, Suite M-019Baltimore, MD 21201410 706 3026 StudentResearch@som.umaryland.edu http://medschool.umaryland.edu/osr

Medical Student Research Day Tuesday, November 19, 2019Noon – 6:45 pmHealth Sciences and Research Facility III (HSRF III) and Medical School Teaching Facility (MSTF)
Judges Availability Form
Extended Deadline: November 15, 2019
MSRD Judge*

I would like to be a Medical Student Research Day 2019 Judge!
First Name:*
Last Name:*
Email:*
Department of (Primary Appointment):
Specify Other Department:
Division of (if applicable):
Group*

FacultyStaffPostdoctoral Fellow or Research FellowResidentResearch AssociateAOA Medical Student MemberOther
Degree(s)
Number of years as a fellow, resident, or research associate
Primary Research Type (select all that apply)*

Basic ResearchTranslational ResearchClinical ResearchPopulation ScienceOther
I would prefer to judge:*

Poster presentationsOral presentationsNo preference
Available to judge more than one presentation session

YesNo
Availability on MSRD for Oral Presentation Sessions

Available Not Available

1:30 - 2:45 pm

	Available	Not Available
1:30 - 2:45 pm

Availability on MSRD for Poster Presentation Sessions

	Available	Not Available
2:55 - 3:55 pm
4:25 - 5:25 pm

Past Medical Student Research Day (check all that apply)

I have been a MSRD judge in a prior year.I have attended MSRD in a prior year.A medical student I worked with presented at MSRD in a prior year.
Comments:
Thank you for volunteering to be a judge for MSRD!
Should be Empty: