Hackathon Challenge - Team Registration
Interested teams need to fill out only one registration form.

This form must be completed by the TEAM LEADER on behalf of all members of your IRIG Hackathon team. Team leader will receive all of the communication from Medical Student Council (MSC) Biodesign and Innovation Committee (BDIC).

Email address *
IRIG Home Institution *
Your Name *
Year in Medical School *
Please list the names, emails and respective years of all other team members in medical school (eg, 1. Jon Doe, Jon.Doe@gmail.com, M2; 2. etc.) *
Did you or your team members participate in last year’s Hackathon? *
Briefly list any relevant work/research experience (if applicable)
Are you a member of SIR? (If not, you will need to sign up to participate. To sign up, please see the link below. Registration is free for medical students.) *
If you are already a member of SIR, please sign into www.sirweb.org and upload a screenshot documenting your membership status *
Required
Please tell us about any special IR device, procedure, or equipment interests you have:
Were you able to identify an IR faculty mentor at your institution? *
IR Physician Mentor Name
IR Physician Mentor Email
Does your institution have an affiliated engineering school or program? *
Required
Additional Comments or Questions: *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Additional Terms