Connors-BRI Advisory Committee Interest Form

Connors-BRI Advisory Committee Interest Form

We plan to review the submissions once a year in February. Those submitted in or before February 2024 have already been reviewed and invited to join the advisory committee. We will review submissions again in February 2025. You can reach out to us at bri@bwh.harvard.edu if you have any questions.
Name*

First NameLast Name
Degree(s)*
Email*
example@example.com
Facutly Rank*

ProfessorAssociate ProfessorAssistant ProfessorInstructorFellowResident
Primary Department Affiliation*
Primary Division Affiliation
Secondary Department Affiliation
Secondary Division Affiliation
1-2 sentences regarding your interest in sex and gender informed science*
Should be Empty: