Transforming Women's Health Outcomes through Engineering: Participant Nomination Form

Transforming Women's Health Outcomes through Engineering:

Participant Nomination Form

General Background

Prefix

Nominee First Name*

Nominee Last Name*

Title

Organization*

Email*

Phone

Primary Discipline or Type of Engineering*

Select or enter value

Sector*

Select or enter value

Career Stage (Years since terminal degree)*

Select or enter value

Link to biography/CV/LinkedIn*

Nominees are strongly encouraged to submit short answers that articulate their thoughts on the event theme.

ERVA and the thematic task force advising the technical scope of the event will use this information to support the selection process.

Attendance at the event is limited. Approved candidates will be invited to attend.

Brief statement: How can your participation make an impact?*

Please briefly describe, from your perspective, how engineering research could transform women's health technologies.

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