Confidential form
To be entered into a lottery to receive a $100 gift card from Amazon, please provide your name and email address in the spaces provided below.
First name
Last name
Email
Please note that by providing your email address here, you are consenting to allowing the Johns Hopkins University and the Institute for Methods Innovation to contact you in the event that you are one of the individuals selected in the prize draw.
If in the future you would like to withdraw your consent to be contacted and would like us to delete your contact information and name, you may do so by emailing
jboyd43@jh.edu
.
Please click
Submit
to send your responses.
Submit