ICS - DECLARATION OF POTENTIAL CONFLICT OF INTEREST (COI) FORM

DECLARATION OF POTENTIAL CONFLICT OF INTEREST (COI) FORM
Download the COI form from HERE, fill it in, and then upload it below
Name

First NameLast Name
Email
example@example.com
Please check the following, as applicable
Please complete, if applicable:
Presentation/Session Title 1
Learning Objectives 1
Presentation/Session Title 2
Learning Objectives 2
Presentation/Session Title 3
Learning Objectives 3
Please upload your completed COI form

Cancelof
I have declared a COI in my completed form
Should be Empty: