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Member Organization Information Request

Copy the text between the lines below, click this link mrz23@case.edu to open your email client, and paste the text into your email client. Fill in the requested information. Alternately, download and complete this Word Doc and attach to the above email address. Please remember to attach or provide links to images in either case!


ORGANIZATION INFORMATION
Organization Full Name (Acronym):

Tagline or Motto:

Website Address:

Organization Logo:

Description (50-150 words):


RESEARCH AREAS
Major Focus (Foci):

Research Types (Clinical Trials, Virology, Microbiology, etc...):

Description of Research (100-200 words):


FACULTY (for each faculty member, please include the following)
Name:

Title within group (if any):

Research Area(s) - General ex. HIV, TB, Tropical Diseases:

Research Focus (Foci) - Specialty ex. HIV Heterogeneity, Multi-Drug Resistant TB, CD40:

Research Focus (Sentence or short paragraph - up to 50 words):

Link to Profile webpage:

Link to picture (if not in profile):


EDUCATION & TRAINING (for each educational opportunity, please include the following)
Program Name:

Link to Program:

Program Description (up to 100 words):


CONTACT INFORMATION
Address:

General Info Email:

Phone:

Instructions for inquiries:


Don't forget to attach logos and images to post on your member group's page in the email. Feel free to add any additional information you find important.

Word doc version

Email this info to mrz23@case.edu.

Thank you!