ONLINE EVENT REGISTRATION
Make sure to submit this form at least one month before event starting date
KSU'S CLINICAL SKILLS AND SIMULATION CENTER
Title of suggested event *
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Write 3 to 5 learning objectives for you Event *
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Write a brief description for your event *
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Target Audience *
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Length of the Event *
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Tentative dates *
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Number of participants( Minimum - Maximum) *
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Type of Learners *
Speciality *
Logistics, Medical Equipments are needed: *
If yes, Please specify: *
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Number of training rooms : *
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Number of Lecture Rooms
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Simulation Modality (its) is\are needed *
Support Services: *
If others, please specify *
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Requester Initials:
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Date of submission:
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Email address *
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Mobile Number
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