West Virginia Rural Health Education Partnerships
Copyright © 1996

Informatics Course Registration

If you wish to enroll in this course, please complete and submit the form below. You will be contacted by electronic mail to confirm your registration, start date and location.

Name:
First Name
Last Name
Desired
Password:
(Min. 6 characters, max. 14 characters. Do not
use a password that you use on any other system.)
Phone:
Email Address:
Start Date: mm/dd/yyyy
Credit:
If Other, specify:
Status:
If Resident or Field Faculty, your department
or specialty:
School /
Consortium:
If Other:
Location:
If Other:
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REVISION: 2 August 1999
WebAdmin@wvrhep.org