Conference Moderator Application
Please complete the form. You will be contacted for a group interview during the month of October.
Email *
First Name *
Last Name *
Home City
Home State
How long have you been a member of WOCIP?
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Why do you feel you would be a good conference moderator?
What day are you available to moderate? *
Mobile Number *
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This form was created inside of Women of Color in Pharmaceuticals.