Poster Session Moderator Application

2021n CORD Academic Assembly Virtually Unstoppable Career Center Advertising Order Form
All orders must be received by March 21, 2021.

Payment must be submitted prior to April 4, 2021.

NO REFUNDS or cancellations after the space deadline on March 21, 2021. Any cancellations must be submitted in writing.

Materials Deadline: The deadline to upload materials in your Virtual Career Center space is April 4, 2021. CORD encourages all early submissions.

Eligibility for Virtual Career Center Advertising

CORD is a scientific and educational organization. It was formed to represent residency program directors, faculty, and their assistants.

In keeping with the current membership of CORD, all Virtual Career Center advertisements must be for educational or academic positions in an Emergency Medicine Residency Program for physicians or administrative staff.

CORD Staff will contact you with instructions on accessing our virtual platform once your completed forms are received and processed.
Name*

First NameLast Name
Company Name*
Title
Email*
example@example.com
Phone*

Area CodePhone Number
Advertiser's Information*
Agency/Billing Information (if different from above)
Payment Options*

Invoice Me (Check Payments)Credit Card
Check Payment Options*

Virtual Space $500.00
Total

Credit Card Payment Options*

Virtual Space$500.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

2021n CORD Academic Assembly Virtually Unstoppable Career Center Advertising Order Form