Sign-ups for med_hack have closed for 2016.

Stay tuned for more in 2017.
 
Hello from the med_hack team!
What is your first name? *

 
Hope you're having a great day {{answer_23967475}}!
What is your last name? *

 
Which institution are you from?

University, Company, High School
 
What is your role at {{answer_23971026}}?

 
Fantastic! Could we please have your phone number? *

 
What is your profession? *

If you are a student, please select student and your future fields!

 
Which profession do you identify with the most? *

Please choose just one! Difficult we know...
 
We would now like to find out a bit more about you. Don't worry about making your answers long - a paragraph should be more than enough for each question.  

If you're getting concerned that you may not have enough experience, don't stress! We're looking for participants from all fields and stages of their career.

 
Tell us about some skills or areas of knowledge you hope to bring to med_hack. *

We're looking for a wide diversity of brain capital!
 
What are some topics you want to learn more about?

 
Tell us about a challenge you've overcome creatively. *

We want to hear a story. Don't forget to show us your passion!
 
Tell us about an idea you have! (Optional)

This question is completely optional! If this is an idea you want to bring to med_hack, please let us know in your answer so we can line up some support.
 
Is there anything you'd like to show us? (Optional)

A great opportunity to show us your CV, Linkedin, Github, Behance, projects, startups, portfolios or blogs so we know a bit more about you! If you're having trouble finding experience or projects, don't sweat as we're looking to help you get started too!
 
Dietary Requirements

 
What's your T-shirt size? *


 
If you are planning to enter med_hack with a team of 4-6, please put down the full names of your team here.

If your team is from a single company, please tell us! 

Disclaimers: Please note we are unable to guarantee entry for entire teams as applicants will be assessed individually. We will give preference to those with a diverse team (multi-disciplinary). Make sure you are comfortable with working with other people before lodging this application.
 
Thank you so much for applying for med_hack. We're so excited to start this journey with you! 

We will get back to you within 5 working days, after which you will have 3 days to purchase tickets from our email. 

28-29th November 2016 | General Assembly, Melbourne
www.medhack.com.au

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