Five-Year Anniversary Event Registration

Name *

First

Last *

Last

Position/Title (for nametag purposes) *

Affiliated School/Department (for nametag purposes) *

Email *

Please indicate which pronouns you would like listed on your nametag: *

She/Her

He/Him

They/Them

Ze/Zim

I would not like my pronouns listed on my nametag

If your pronouns are not represented above, please share here:If your pronouns are not represented above, please share here:

Which best categorizes your relationship with Precision Health at U-M? *

Precision Health Member (Data/resource user)

Researcher/Faculty with interest in Precision Health (not yet a member)

Stakeholder/Supporter of Precision Health

Precision Health partner organization

Precision Health Staff

Other (please describe):Other (please describe):

Members are invited to engage in Strategic Planning from 12:30-3pm, to help guide the future of Precision Health. Can you participate?

Yes, I plan to stay from 12:30 - 3:00pm!

Maybe - I hope to stay from 12:30 - 3:00pm

No, I cannot stay from 12:30 - 3:00pm

We are glad you'll be attending! We are offering a special gift to each attendees who brings a colleague with them

Yes, I have a colleague/colleagues who will join me

I might have colleagues who are interested; can you send them an invitation?

No, I do not plan to bring along any colleagues

Please share name and email of colleagues you would like to invite:

Do you have any dietary needs/restrictions we should be aware of? *

Receive email updates

I would like to receive email updates regarding future conferences

Comments or Questions