Guangzhou Course registration

Please use the form below for course registration. The registration process is not complete until we have received payment.

REGISTRATION INFORMATION

Given Name: *

Family Name: *

Degree: *

Department: *

Institution: *

Address 1: *

Address 2:

City: *

State: *

Postal or Zip Code: *

Country: *

Email: *

Contact Telephone: *

Which course are you planning to attend?: *

2011JUL SPM8 for Basic and Clinical Investigators - Guangzhou

Registration type: *

Faculty

Post-doctoral fellow

Student

Affiliation: *

South China Normal University investigator

Other

Payment type: *

Institutional or bank check

PAYPAL

Cash

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The full workshop fee is $1500. Reduced rates of $1250 for post-doctoral fellows and $1000 for undergraduate, graduate or medical students are available. A 20% discount on these rates is available to all South China Normal University investigators. We must receive your tuition payment 4 weeks prior to the course to guarantee your registration. Please contact us should special arrangements need to be made regarding payment. Course fees are refundable up to 14 days prior to the session. =======================================================================================
TO PAY BY INSTITUTIONAL or BANK CHECK, please make check in $USD payable to: Neurometrika. Please include (on the check or separately): YOUR NAME YOUR EMAIL ADDRESS PROGRAM NAME (code or dates) FOR WHICH YOU ARE REGISTERED. Bring the check to the course.
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To pay using PAYPAL, follow the instructions on the workshop website.
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Payment can also be made in CASH in $USD at the time of the course.

Biosketch Information

In preparing for the course, it helps us to know a little about your background and interests. In the fields below please tell us about your background (academic, clinical, research, industrial, or other), and experience with functional neuroimaging. This is also an opportunity to state what you most hope to learn about during the course.

Educational Background: *

Please describe your educational background, particularly with respect to coursework in experimental design, statistics, and signal processing.

Years of fMRI Experience: *

Work Environment: *

Please describe your current work environment including imaging facilities.

Research Interests: *

What psychological or physiological domains are of most interest to you?

Educational Goals: *

What are your goals in attending the course? Are there particular topics you want to hear about?

Your Photograph:

Please send us your photograph, so we can recognize you at the course..

Questions:

Do you have any questions about the course?

Neurometrika

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Guangzhou Course registration