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Basic Info

First Name: *

Last Name: *

Email: *

Phone: *

Former FDA Employee?:

Please check this box if you are a former employee of the Food & Drug Administration

Expert Witness:

If you are a former FDA employee, and are interested in Expert Witness work, check this box

Pharmaceuticals:

Please check the box if you have experience working in Pharmaceuticals

Medical Device:

Please check the box if you have experience working with Medical Devices

Quality:

Please check the box if QA or QC is your area of expertise

Regulatory Affairs:

Please check the box if Regulatory Affairs is your area of expertise

510K:

Please check the box if 510Ks are your area of expertise

Pharmacovigilance:

Please check this box if Pharmacovigilance is your area of expertise

Auditor:

Please check the box if you are a certified auditor

GLP:

Please check the box if you have GLP experience

GCP:

Please check the box if you have GCP experience

GMP:

Please check the box if you have GMP experience

Address Information

City: *

State/Province: *

Country: *

Professional Details

Interested in: *

Please select the type of work you are interested in hearing about

Remote only:

Please check this box if you are only interested in remote work/projects

Content contributor:

Please check box if you are interested in contributing to webinars, whitepapers, newsletters, etc.

Hourly Rate or Annual Salary: *

Enter your hourly consulting rate (i.e. 100.00) or target annual base salary (i.e. 100000)

Other Info

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Attachment Information

Resume: *

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