The code block below illustrates how one might use # and // as comments in your logic and calculations.

# Text can be put here to explain what the logic/calculation does and why.
if ([field1] = '1' and [field2] > 7,

	// This comment can explain what the next line does.
	[score] * [factor],

	// Return '0' if the condition is False.
	0
)

Working...

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

Data and Safety Monitoring Board (DSMB) Training Registration Form2

This training aims to expand the pool of qualified DSMB members by enhancing the availability of trained experts. The program supports the ethical oversight of vaccine trials and improves global preparedness for emerging health threats. This 8-week training program includes self-paced learning and live virtual sessions facilitated by leading experts in vaccine safety and clinical trial monitoring. Upon successful completion, participants can join the DSMB Pool, where they may be considered for future clinical trial oversight roles.

Africa CDC and CEPI/SPEAC jointly sponsor this training to equip professionals with the necessary skills for effective safety monitoring in clinical trials, contributing to improved research quality and public health outcomes.
Goals

1. Personal Information
Title
Sex
First Name
Surname/Family name
Country of Nationality
Mobile Number
Email

2. Professional Background
Current Employer/Organisation
Type of Institution
Job Title/Role:
Years of Professional Experience
Highest Educational Qualification:

3. Do you have a background in clinical trials or vaccine pharmacovigilance?

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Yes No

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If yes, please briefly describe your background:

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4. Do you have experience working on clinical trials?

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Yes No

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If yes, how many years?

5. Do you have experience in conducting active pharmacovigilance activities?

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Yes No

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If yes, please describe the type of active PV activities and your role:

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6. Please describe your motivation for attending this training(max 500 words)

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7. Upload a support letter from your organization

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8. Upload CV

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Any other comments?

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Declaration and Consent

I confirm that the information provided is accurate and complete.

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I consent to the use of my information for selection and communication purposes related to this training.

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