RSVP for 2017 Central Clinical School (CCS) Public Lecture: "Changing the way we treat diabetes and its complications"
You are RSVPing to the CCS Public Lecture, 6.30 - 8.30 pm, Thursday 19 October 2017, being given by Professor Mark Cooper AO, Head of the Department of Diabetes at Central Clinical School, Monash University. The lecture is being held at the AMREP Lecture Theatre between the Baker & Burnet Institutes, 75-85 Commercial Rd, Melbourne VIC 3004. See details at
First name *
Your answer
Last name *
Your answer
Email *
We will confirm your RSVP prior to the lecture and post you a link to the video once published.
Your answer
Phone number
This is useful in the event that you entered your email incorrectly.
Your answer
Number of people attending, including yourself, in numerals *
You are welcome to bring one or more people. If just yourself, then please enter '1'.
Your answer
How did you hear about this event? *
*Monash alumni ID number (if applicable):
Your answer
Would you like to receive CCS news notifications?
Central Clinical School produces a weekly enews distributed by email, and holds one public lecture annually. See news blog link:
Never submit passwords through Google Forms.
This form was created inside of Monash University. Report Abuse - Terms of Service