COURSE APPLICATION FORM

Emerging Techniques in Protein and Genetic Engineering

July 26-30, 2010

Name
Address
City
State
ZIP/Postal Code
Country
Phone
Fax
E-mail

Please indicate the appropriate participant category for your application:
Student: would enroll through BTCI, i.e. no UW credits (course fee: $1,200)
Company / other organization employee: would enroll through BTCI; i.e., no UW credits (course fee: $1,500)
University of Wisconsin-Madison student or special student: would enroll for UW-Madison credits (course fee: tuition paid to UW-Madison)

    

ADDITIONAL REQUIREMENTS:

  • As well as the course application form, a letter or interest, clarifying eligibility and professional need for course content must be submitted by May 10. This letter can be faxed, e-mailed or mailed to Dr. Karin Borgh.
  • Course enrollment is limited to 20 participants, with approval for enrollment to be granted by Dr. Karin Borgh, based upon review of application materials.