Introduction to Molecular Biology Techniques Workshop - Application Form

Further information about this workshop is available here.

Please complete the following application form and submit it by Monday 20 Feburary 2012. You can save a draft of your application at any time by clicking 'Save Draft' at the bottom of the page.

Personal Details

Title: *

First Name: *

Surname: *

Member ID (if applicable):

If you are a Member, please indicate your membership type:

Ordinary

Affiliate

Position: *

Organisation: *

Address: *

City: *

Country: *

Postal/Zip Code: *

Telephone number (including international code if outside UK): *

Email: *

Personal Email:

Please tick this box if you would like The Society to contact you in future using this email address:

Yes

Qualifications

Please provide details of qualifications gained since leaving school, including degree/designation, institution and year: *

Other Information

How much previous experience have you had with Molecular Biology?: *

How did you hear about this workshop?: *

What do you hope to achieve through attending this workshop?: *

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Introduction to Molecular Biology Techniques Workshop - Application Form

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