Step 1

 

The C.A.S.T. Registration
Community Advocacy Site Training

Date:  Friday, April 4, 2014, 4:00 – 8:00 p.m.


Oak Cliff Bible Fellowship Educational Conference Center, 1821 W. Camp Wisdom Rd, Dallas, TX 75232
For Site Investigators, Clinical Research Coordinators, Nurses, CRO’s. ARO’s, Clinical staff, Et al.

 

Full Name

First Name (*Required) Last Name
Title Suffix
Email (*Required)    

Organization/Clinical Trial

Name of Organization
Clinical Trial Disease
(i.e. Breast Cancer)
Study ID#/Type:
Name of Trial
Stage of Trial
Primary Completion Date

Contact Information

Street Address #1
Street Address #2
City State
Zip    
Website Department
Phone Extension
Fax    
Are you:

Registration Details

 

Cost: $250 per participant or
$150 each for 2 or more 

(Workbook, Directories, Light Reception & Dinner included)


Registration Deadline: Friday, March 14, 2014
For more information: Phone: 972-517-1254

Number Attending
Payment Amount
Note: Payment will be made on the next screen.
 

Reserve Early. Limited Seating
NOTE:  Only pre-registered participants will receive Workbooks and Certificates of Completion on day of event.
Day of event registrants will have a 2-week delay in receiving Workbooks and Certificates of Completion.