VAST Registration Form

The information collected will be held by the VAST Team and will not be shared.

Required fields are marked with a *

Course Info
Course Date*	Please input a YYYY-mm-dd date (2020-10-13)
Course Type*
Course Location*
Course Role
Personal Info
Last Name*
First Name*
Clinical Role*
Workplace*
Prior Simulation Experience*	Have you attended a simulation course before?
Email*
Home Country*
Gender*
Mailing List	Would you like to join the VAST Mailing List to receive correspondence and updates from VAST in the future?
"Human check"*	10 + 3 = ? Please answer the math problem above