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Clinical Simulation Center
Instructor Training Registration
 

Course Date and Time
Last Name*
First Name*
Unique Name*
UMID Number*
Email Address*
Profession*
Department*
Short code to bill* (If dept. is paying enter six-digit short code or if paying out of pocket, enter 999999)

*= ALL fields required for registration

NOTE: You are not registered until you get a confirmation EMAIL.

If you have any questions, or paying out of pocket, contact Michael Marsh at 734 647 5619