Registration Form for the Workshop "Inequality in Myeloproliferative Diseases and Acute Leukemia Mortality and Surveillance: Historical and Contemporary Perspectives" Yerevan, Armenia | October 3–5, 2025. For more information, visit the greatleap.eu. Please use this form to register before May 1, 2025.

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Registration Form for the Workshop "Inequality in Myeloproliferative Diseases and Acute Leukemia Mortality and Surveillance: Historical and Contemporary Perspectives" Yerevan, Armenia | October 3–5, 2025. For more information, visit the greatleap.eu. Please use this form to register before May 1, 2025.

Без названия

1. Email Address:

Please provide a valid email address for correspondence.

2.⁠ ⁠Full Name:

Please provide your first and last name.

3.⁠ ⁠Affiliation(s):

Please indicate your institution, organization, or university.

4.⁠ ⁠Areas of Expertise:

What are your areas and levels of expertise in data analysis and working with statistical programs? Please provide a brief description.

5. "What are your areas and levels of expertise in oncohematology, including your experience with specific diseases, treatment protocols, or research methodologies?" *

6.⁠ ⁠What applies to you?

Please select your current academic or professional status:

PhD Student

Postdoc Researcher

Senior Researcher (Including Professors, etc.)

Clinician (e.g., Doctor, Nurse, Medical Professional)

7. Participation Type:

How would you like to participate in the workshop? (Check all that apply)

I am interested in presenting my research.

I am attending to learn and engage in discussions.

I am participating as a facilitator or organizer.

8. Special Requirements:

Do you have any accessibility or other specific requirements for attending the workshop? Please specify.

A. Yes, please specify: _____________

B. No, I have no special requirements.

9. Workshop Materials:

Would you be interested in receiving workshop materials (presentations, papers, etc.) in advance or after the event?

Yes

10. Comments or Questions:

Please provide any additional information, questions, or comments you may have regarding the workshop.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms