Award for Excellence in Human Research Protection
Become sponsor

Name: ________________________________________________________________________

Title: _________________________________________________________________________

Company: _____________________________________________________________________

Address: ______________________________________________________________________

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Telephone: ____________________________________________________________________

Fax: _________________________________________________________________________

Email: ________________________________________________________________________

We are interested in the following sponsorship opportunities:

[ ] Sustaining sponsorship of the Award program
[ ] Sponsoring an Award, one of the following:
[ ] Best practice
[ ] Innovation
[ ] Life-time achievement
[ ] Sponsoring an event or activity, for example:
[ ] Award announcement, call for entries, etc
[ ] Award website
[ ] Award dinner
[ ] Sponsoring national educational workshops
[ ] Contributing to this year's Award program
[ ] Other, please specify below.

Remarks/requests — if necessary, please attach additional sheets

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