Course registration - DO NOT USE - PLEASE GO TO THE PAGE FOR A SPECIFIC COURSE

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?: *

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Registration type: *

Regular

Post-doctoral fellow

Student

Affiliation: *

MGH employee

Other

Payment type: *

Personal or institutional check

PAYPAL

Cash

The regular fee is $1500. Reduced rates of $1250 for post-doctoral fellows and $1000 for undergraduate, graduate or medical students are available. A 20% discount is available for MGH employess.
We must receive your tuition payment four 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 30 days prior to the session.
A $200 fee will be deducted, should you request a refund up to one week prior to the program. After that, the tuition can be applied to a future program. =======================================================================================
TO PAY BY PERSONAL OR INSTITUTIONAL CHECK, please email spmbasics@neurometrika.org if you wish to utilize this option.
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TO PAY USING PAYPAL, follow the instructions on the workshop website.
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TO PAY USING CASH in $USD at the time of the course, please email spmbasics@neurometrika.org if you wish to utilize this option.
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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?

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Course registration - DO NOT USE - PLEASE GO TO THE PAGE FOR A SPECIFIC COURSE