Public Health Informatics:
Science to Practice with Transdisciplinary Collaboration
Tuesday, September 24, 9:30 a.m. - 4 p.m.
The William and Ida Friday Center for Continuing Education
Chapel Hill, N.C.

Participant Category:
Title:
First Name:
Last Name:
Badge Name:
PID:
Job Title:
Department:
Organization:
Fee Due:
Payment Method: Check
MasterCard or Visa
Paid by UNC Dept on account #:
(Red captions indicate required fields.)
Address Line 1:
Line 2:
Line 3:
City:
Country:
Postal:
Email:
Phone:
Fax: