UNC Gillings School of Global Public Health

North Carolina Institute for Public Health

The Board of Health Rulemaking Authority: A Primer for Local Boards of Health (HCE6390114)

* Required items
*First Name
Middle Name
*Last Name
*Gender Female Male
*Birthdate Month: Day: Year:
Why do we require your gender and birthdate?
Agency type
Job title/position
*Mailing address
*Zip code
  This is my home work address.
*E-mail Address
Home phone Area code + number
Work phone Area code + number
Area code + number
*Are you a student, faculty member, or staff member at UNC-CH?  No  Yes 

If yes, please enter your PID:
Are you a graduate of the UNC-CH School of Public Health? No Yes, department: 



Why do we require your birthdate and gender?

We ask that you provide your birthdate and gender with the understanding that they will be used only as identification for internal record keeping and data processing operations at the University of North Carolina at Chapel Hill.

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