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Office of Faculty Development
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ffice for
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aculty
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xcellence
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INSPRE Program
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INSPRE Registration Form
INSPRE REGISTRATION FORM
Please complete and submit the form below to register for INSPRE. Once you click Submit, you will receive an e-mail from us to confirm your registration.
First Name:
Last Name:
Degree:
--Select--
MD
PhD
Other
Academic Rank:
--Select--
Professor
Associate Professor
Assistant Professor
Instructor
Clinical Professor
Clinical Associate Professor
Clinical Assistant Professor
Clinical Instructor
Research Professor
Research Associate Professor
Research Assistant Professor
Research Instructor
Resident
Lab Assistants
Post-Doc
Graduate Student
Other
Not Applicable
Department:
--Select--
Academic and Faculty Development
Academic Support and Enrichment Center
Adult Health Nursing
Anatomy and Cell Biology
Biochemistry
Biostatistics
Cardiovascular Center
Center for Health Sciences Communication
Center for Health Services Research and Development
Clinical Laboratory Science
Clinical Trials Office
Communication Sciences and Disorders
Community Health
Comparative Medicine
Compliance
Continuing Medical Education
Diabetes Clinical Research Center
Eastern Area Health Education Center
Eastern Carolina Cardiovascular Institute
ECU Physicians
Emergency Medicine
Health Services and Information Management
Family & Community Nursing
Family Medicine
Generalist Physician Program
Group Practice Administration for ECU Physicians
Health Sciences Development & Alumni Affairs
Information Technology & Computing Services
Institutional Review Board
Internal Medicine
Laupus Library
Leo W. Jenkins Cancer Center
Medical Center News and Information
Medical Education
Medical Foundation of ECU
Medical Humanities
Microbiology and Immunology
Obstetrics/Gynecology
Occupational Therapy
Pathology and Laboratory Medicine
Pediatric Healthy Weight and Treatment Center
Pediatrics
Personal Counseling Center
Pharmacology
Photodynamic Therapy Center
Physical Medicine & Rehabilitation
Physical Therapy
Physician Assistant Studies
Physiology
Prospective Health
Psychiatry
Radiation Oncology
Regional Rehabilitation Center
Rehabilitation Studies
Research & Graduate Education
Risk Management & Compliance Office
Student Affairs
Surgery
Telemedicine Center
Other
Not Applicable
Office Address:
E-mail:
Daytime Phone:
Comments:
Gender:
--Select--
Male
Female
Provision of this information is voluntary. It will be used for non-discriminatory purposes such as determining how we might effectively meet the diverse needs of faculty.
Specify Other:
Please specify your degree if not found on the selection list above.
ECU Health Sciences Affiliation:
--Select--
College of Allied Health
College of Nursing
Brody School of Medicine
Laupus Library
School of Dentistry
Not Applicable
Specify Other:
Please specify your affiliation if not found on the selection list above.
Specify Other:
Please specify your department if not found on the selection list above.
Specify Other:
Please specify your academic rank if not found on the selection list above.