2024 Symposium Proposal

2024 Symposium Proposal

Submission deadline December 15, 2023
Title of Symposium:*
Summary of Symposium*
Target Audience*
Chairperson

If the chair/co-chair is presenting, please also list them as a speaker
Chairperson Name*

First NameLast Name
Chairperson Email*
example@example.com
Chairperson Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Co-Chairperson

Optional
Co-chairperson Name

First NameLast Name
Co-Chairperson Email
example@example.com
Co-Chairperson Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Speaker 1
Title of Contribution:*
Speaker 1 Name*

First NameLast Name
Speaker 1 Email*
example@example.com
Speaker 1 Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."*
Speaker 2
Title of Contribution:*
Speaker 2 Name*

First NameLast Name
Speaker 2 Email*
example@example.com
Speaker 2 Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."*
Speaker 3
Title of Contribution:*
Speaker 3 Name*

First NameLast Name
Speaker 3 Email*
example@example.com
Speaker 3 Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."*
Speaker 4
Title of Contribution:
Speaker 4 Name

First NameLast Name
Speaker 4 Email
example@example.com
Speaker 4 Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."*
Speaker 5
Title of Contribution:
Speaker 5 Name

First NameLast Name
Speaker 5 Email
example@example.com
Speaker 5 Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."*
Speaker 6
Title of Contribution:
Speaker 6 Name

First NameLast Name
Speaker 6 Email
example@example.com
Speaker 6 Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At least one Learning Objective completing the following sentence: "Upon Completion of this CME activity, participants should be able to...."
Symposium Submission Checklist

All speakers have agreed to participate in the symposium. Submitting a proposal without the consent of each participant may lead to disqualification.Correct email address included for each participant.Symposium form content is complete. Required content includes: Title, summary, learning objectives, and target audience.All speaker information is complete. Required content includes: Title of contribution, first and last name, country, and email address.
Should be Empty:

2024 Symposium Proposal

Chairperson

Co-Chairperson

Speaker 1

Speaker 2

Speaker 3

Speaker 4

Speaker 5

Speaker 6