Registration: PCBs: An Update

This is the registration form to view our livestream program, "PCBs: An Update" on Monday, September 25, 2017, 12:00 pm - 1:00 pm EDT with Lisa Rodenburg, PhD, with Rutgers University - Department of Environmental Science.

1. First Name *This question is required.

2. Last Name *This question is required.

3. Email Address. Please enter (and review!) this carefully as the links to view and evaluate this program will be emailed to you. *This question is required.

4. Job Title *This question is required.

5. Organization *This question is required.

6. Which is the U.S. state/ territory/ commonwealth where you work? *This question is required.

7. Please select your employment setting (check all that apply) *This question is required.

Primary Care
Medically Underserved Community
Rural Area
None of the above

8. Please select your primary profession/discipline. *This question is required.

9. How confident are you that you can: *This question is required.

Space Cell	Not at all confident	Somewhat confident	Moderately confident	Very confident
Understand what PCBs are and where they come from	Understand what PCBs are and where they come from: Not at all confident	Understand what PCBs are and where they come from: Somewhat confident	Understand what PCBs are and where they come from: Moderately confident	Understand what PCBs are and where they come from: Very confident
Identify the effects of PCBs on humans and the environment	Identify the effects of PCBs on humans and the environment: Not at all confident	Identify the effects of PCBs on humans and the environment: Somewhat confident	Identify the effects of PCBs on humans and the environment: Moderately confident	Identify the effects of PCBs on humans and the environment: Very confident
Explain methods to clean up PCB contamination	Explain methods to clean up PCB contamination: Not at all confident	Explain methods to clean up PCB contamination: Somewhat confident	Explain methods to clean up PCB contamination: Moderately confident	Explain methods to clean up PCB contamination: Very confident

10. Please select the reason you are attending this webinar (please select all that apply) *This question is required.

to learn more about the specific webinar topic
the webinar topic relates to my work
general interest in staying informed about public health practice
general interest in staying informed about current public health research
to obtain continuing education credits
Other (please specify) Please enter an 'other' value for this selection. * This question is required.

Registration: PCBs: An Update

Webinar Registration