Request to Join InCHIP Research Interest Groups Name* First Last Email* What role do you currently have?*UConn FacultyUConn StaffUConn Graduate StudentUConn Undergraduate StudentNon-UConn FacultyStaff/Researcher at Community Organization or Government AgencyIndustry ResearcherWhat department, center, institute, or office is your primary appointment through?*What company, organization, or institution do you work for?*Which research groups would you like to join?* Aging Research Interest Group Cancer Research Interest Group Collaboratory on School and Child Health eHealth/mHealth Research Interest Group HIV Research Interest Group Interprofessional Healthcare Research Interest Group Obesity Research Interest Group InCHIP’s RIG’s provide forum for researchers to connect with other researchers in person and via the RIG’s respective listserv. Do we have your permission to add your email to the RIG listserv(s)?*YesNoNameThis field is for validation purposes and should be left unchanged.