Case Competition Registration - SHP - Health Administration Case Competition

Each CAHME-accredited graduate program may send ONE team of up to three students. Registrations will be accepted on a first-come/first-served basis up to the maximum of 36 teams. Please complete this online registration form with a registration fee of $250 per team member, $150 per student observer, and $150 per faculty attendee. By December 20th, we need to know if your university plans to participate, how many team members will compete, number of faculty members, number of student observers and payment of your registration fee. We will send a request for the Team Members' contact information in January before the case is distributed.

If you need assistance or have questions, please contact: Randa Hall, randahall@uab.edu or (205) 934-3332.

University Name: (*)

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Does your faculty adviser plan to attend the UAB Health Administration Case Competition?

Yes

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How many Faculty Advisers will be attending?(*)

Please enter numeric value.

How many Team Members will be attending?(*)

Please enter numeric value.

How many Student Observers will be attending?(*)

Please enter numeric value.

Request for Video(*)

Yes, we would like to purchase the video.

No, we do not wish to purchase the video.

Please choose whether you would like to purchase the video.

Does your university require an invoice?

Yes

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Faculty Adviser Information

Faculty Adviser's Full Name (including degrees Ph.D., DSc, etc) (*)

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Faculty Adviser's Email(*)

Please type your faculty advisor's email address.

Faculty Adviser's Mailing Address(*)

Please add your faculty advisor's address.

Faculty Adviser's City, State Zip(*)

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Name of Second Faculty Adviser

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2nd Faculty Adviser's Email Address

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Faculty Adviser #2 Mailing Address

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Faculty Adviser # 2 City, St Zip Code

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Team Member Information

Add a Team Captain

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Team Captain's Name

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Team Captain's Email

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Team Captain's Cell Phone (include area code but no dashes or parentheses)

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Team Captain's Mailing Address

Please enter a mailing address.

Team Captain's City, State Zip

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Please upload the Team Captain's Resume

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Add a Team Member

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Team Member #2

Name

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Cell Phone (include area code but no dashes or parentheses)

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Mailing Address

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City, State Zip

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Resume for Team Member 2

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Add another team member

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Team Member #3

Name

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Cell Phone (include area code but no dashes or parentheses)

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Mailing Address

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City, State, Zip

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Resume for Team Member 3

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Faculty Advisers and Student Observers may attend for an additional $150 fee per person.

Student Observer Information

Add a Student Observer

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Name of Student Observer #1:

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Email Address of Observer #1:

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Resume for Observer 1

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Add another Student Observer

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Name of Student Observer #2

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Email Address of Observer 2:

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Resume for Observer 2

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PAYMENT METHODS:

Payment by Check:

You may pay with a non-refundable check for the appropriate amount, based on the number of team members, student observers, and faculty members attending. MAKE PAYABLE TO: The University of Alabama at Birmingham. Address for envelope: Attention: Randa Hall, The University of Alabama at Birmingham (UAB), 1705 University Blvd. SHPB Room #568, Birmingham, AL 35294-1212.

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- or -

Payment with Credit Card:

Credit card

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(*)

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