ICBEM 2024 Conference Abstract Form
Contact Information
Full Name
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First Name
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Institution / Organization
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Department
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E-mail Address
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Please use the same email used for registration
Re-Enter Email
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Are you an Invited Speaker
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Yes
Have you already registered?
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Not yet but will soon
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Abstract Information
Abstract Title
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Enter ONLY the abstract title here. Please capitalize the first letter of your title. Do not add a period at the end of your title. This will be used for printing in the final program. 100 character limit.
Name of Presenting Author
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First Name
Last Name
All Authors & Affiliations
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You must enter the names of ALL AUTHORS and affiliations here (including yourself if you are an author) inthe order in which you wish them to appear in the printed program. Underline the presenting author name.
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Abstract Body
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Maximum 300 words
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Funding Acknowledgement(s)
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Travel Award Eligibility
Please indicate if you are a/an:
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Post-Doc
Resident
Grad Student
Medical Student
Clinical Fellow
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Have you received an ICBEM travel award in the past?
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Yes
No
Do you wish to be considered for a Travel Award? (Deadline: Feb 23)
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Yes
No
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Travel Award Application
How will this award help you?
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Upload Proof of Student/Trainee Status
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A letter from your supervisor confirming your status is required to be considered for a Travel Award.
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Upload your CV
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Do you identify with any of these racial or ethnic categories?
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American Indian or Alaska Native
Asian
African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
White/Caucasian
Other
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Confirm & Submit
If my abstract is selected, I agree to attend in person to present my work
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Yes
I confirm that all authors grant permission to publish this abstract in the official meeting program and on electronic media.
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Yes
Signature
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