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Register

Clinical Site Coordinator / Manager and GCP Virtual Workshop

To Register Online, complete and submit the form below.

Non member fees include a one year membership in SOCRA.
Membership fees are processed immediately and are not refundable.
Fees are in U.S. dollars.
Written cancellation requests received by SOCRA at least 10 business days prior to start of course may receive a partial refund.
We regret that refunds cannot be issued for cancellations on or after 10 business days prior to start of course.
Taping (audio or video) is prohibited unless SOCRA’s written permission has been acquired.
ADA - This program is accessible to persons with disabilities. Please list any special needs in the area indicated in the registration form.
SOCRA is an educational non-profit membership organization (corporation) - Federal Tax ID #61 1208981.

Name Prefix

Name

First Name

Middle Initial

Last Name

Degrees

Certifications

Title

Company / Affiliation

Address Line 1

Address Line 2

City/State/Zip

City

Zip/Postal Code

Province (outside US/Canada)

Country

Phone

Fax

Alt Phone

Cell Phone

Email Address

ADA - This program is accessible to persons with disabilities. Please request any special accommodation

Name on Card

First Name

Last Name

Billing Address

Street Address

Zip/Postal Code

Credit Card

Card Number

CCV Code

Expiration Date

Amount