Chair Application

First Name

Last Name

Phone

Email Address

Address

City, State, Postal Code

Are you a current or former IRB Advisors Chair or Member

Yes A

No B

How Many Years of IRB/HRPP Experience do you have

+ -

How many business hours per month are you able to commit ?

+ -

Please cut and paste your resume or CV in the space provided.

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Note: Please fill out the fields marked with an asterisk.

Thank you for your interest in becoming a Peer Advisory Committee Chair. Any information you provide will be strictly confidential. Once your application has been reviewed, a representative will contact you by phone and/or email. Please send inquiries or comments to info@irbadvisors.com or call (347)671-9867 for further details.

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