Multicenter  AIDS  Cohort  Study

Personnel Information

Please fill out the following form for:

  • updates (besides required fields, only include information that has changed),
  • deletions (required fields only)
  • additions (include all fields).
Use the comments box for any additional comments or instructions.
Type of change: * Required field
Your last name: * Required field
Your first name: * Required field
Name Tag:
(Name to appear on name tag for meetings)
* Required field
Your degree: (i.e., PhD, MD, etc.)
Your MACS function/title: (i.e., Epidemiologist, Lab Technician, etc.)
Your email address:
Your Organization:
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Your mailing address:
   (maximum 6 lines allowed)
Your FedEx address:
   (maximum 3 lines allowed)
Your Voice Telephone:
Your Fax Telephone:
Your Beeper Telephone:
Your Working Group(s) participation:
(Hold down CONTROL to select multiple working groups)
Additional Comments or
       special instructions: