RSVP Form - Faculty Development Lecture April 2025

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

Malaria - An Ancient Foe. Recognizing World Malaria Day

*This is not a CME activity.

Date: Wednesday, April 16, 2025

Time: 12 p.m.
Location: S-300 and Zoom

Please provide your name, email address, and phone number to advise the Office of Faculty Affairs at the University of Illinois College of Medicine Rockford of your attendance.

Pizza lunch will be provided for in-person attendees. If you will be attending in person, please indicate any dietary restrictions.

Thank you.

Name *

Please provide your email *

Title *

Physician

Student

Other:

Phone number *

Do you plan to attend in person? *

Yes

If attending in person, please indicate any dietary restrictions.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of University of Illinois Chicago.

Does this form look suspicious? Report

Forms