Ethics Registration..

Training for Ethics Committee Members Date: 29th June 2019 Time: 8.00 AM – 1.30 PM, Venue: Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar

Full Name*

Designation

Institutional Affiliation

Department

Current Address*

City*

State*

Contact Details

Email ID*Enter valid email id

Confirm Email ID*Enter valid email id

Mobile No*Enter valid mobile number

Participating as *

Member of Ethics Committee

Faculty/Scientist

Name of the ethics committee where you are a member
How long have you been a member of EC	Year Month
Have you attended any earlier ethics training program (last 3 years)	Yes No

(A confirmation email with registration details will be sent to you on email mentioned above.)

Note :- All * fields are mandatory