2017 Friesen Prize Dr. Alan Bernstein, President,CIFAR "Health Research in an Age of Borderless Science: How Can Canada Best Contribute?"

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* 1. First Name

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* 2. Last Name

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* 3. E-mail Address

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* 4. Institution / Organization / Company

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* 5. Type of Institution / Organization / Company (Choose all that apply)

University / College / Academic Institution

Hospital

Industry

Government

Non-profit Agency

Media

Other (please specify)

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* 6. Professional Role / Title and Department if applicable

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* 7. Will you be attending the light lunch (12:45 pm to 1:30 pm) following Dr. Alan Bernstein's Lecture at U Ottawa on Tuesday, October 31, 2017?

YES

NO

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* 8. Have you attended previous Friesen Prize Program events?

YES

NO

What years?

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* 9. Will you review the FCIHR web site: www.fcihr.ca ?

Yes

No