Child Health and the Law Conference 2008 Registration

Sponsored by the Medical-Legal Partnership for Children at Boston Medical Center and the Child Advocacy Program at Harvard Law School

Thursday, April 24, 2008

Contact Info

Last Name *

First Name *

Email Address *

Home Address *

City *

State *

Zip Code *

Phone Number

School Information

School/Affiliation *

Year in School *

Specific areas of interest or expertise, if any

Past Conferences

How did you find out about the Child Health and the Law Conference?

Have you attended a past Child Health and the Law Conference?No, this will be my first conferenceYes, I attended the 2007 conferenceYes, I attended the 2004, 2005, or 2006 conference

Workshops

Workshop preferences. Please rank these workshops (1,2,3,etc), with 1 being the workshop you would most like to attend. We will assign each participant to 2 workshops. Education *

Health Insurance *

Housing *

Immigration *

Nutrition *

Safety *

Other Information

Special Needs. If you have a disability that requires assistance, please indicate what accomodations you may require.

Dietary Needs. Please indicate below if you have any special dietary needs (vegetarian, foods allergies etc).

Please provide any other information you feel is necessary/relevant

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