CORRECTION: MWIA Centennial Meeting Abstract Correction Submission Form

MWIA Centennial Meeting

Abstract Submission Form
The Medical Women's International Association (MWIA) Centennial Congress will be held July 25 - 28, 2019 in New York City. We invite you to submit your poster abstract using this form.

By submitting your poster to us, you are agreeing that we may distribute your poster to MWIA Congress attendees via an online portal or in print.

Posters that align with the MWIA Centennial Congress topics are encouraged. These include:

Gender specific medicine • Global health • Healthcare & technology • Gender equity • Women physicians: balancing career and family • Medical students, generation Y • Aging and women • Violence against women • History of medical women • The obesity epidemic • Impact of climate change on health • Women's health

Submission Guidelines:
- Each unique poster abstract must be submitted individually using this application form (e.g. if you have more than one abstract you'd like to submit, you must complete this form for each abstract).
- All author names and email addresses are required and ALL authors must sign off on submission for the abstract to be eligible for consideration. An email will be sent to each author for their electronic signature approving the abstract at the bottom of the submission form.
- The submitting author must be available to present at the conference.
- The poster abstract must be 2000 characters or less (author names do NOT count toward word limit and 250 characters should be deducted for any graphic charts).
- There is a one-time, non-refundable $40 poster application fee
- Formatting:
  For Scientific Research: Authors’ names (ex. Smith, Jane, L.), Hypothesis, Methods, Results, Conclusions
  For Clinical Cases: Authors’ names (ex. Smith, Jane, L.), Case, Conclusions, Clinical Significance
- Please enter your abstract information as accurately as possible, as it will not be able to be changed after submission of this form.
The early deadline to submit is September 1, 2018. Those submissions may also be considered for presentations. The late deadline for poster abstract submission will be February 28, 2019. These abstracts will not be considered for formal presentation during breakout sessions but will be considered for the scientific poster session. Questions? E-mail amandaxi@amwa-doc.org
Personal Information
Name*

First NameLast NameDegrees/Fellowships (e.g. MD, MPH, FACP)
E-mail*
Phone Number*

Area CodePhone Number
Institution/Affiliation*
Country*
Please indicate if you are a*
YesNo
Title*
If you selected "Other", please describe below:
Do you or any of your co-authors have any financial disclosures?*
If you have financial disclosures, please describe below:
How many co-authors are listed on your abstract, including yourself (Please enter a numerical value between 1 and 10. ex. 3)?*
Have ALL abstract authors agreed to poster submission & abstract publication in the MWIA Conference Abstract Booklet, which may be published online or in print? (ALL authors will be notified of your submission.)*
Please enter the names and email addresses of the co-authors in the text fields below (INCLUDING yourself). These fields will only be present if you have entered a numerical value other than 0 above (do not worry about entering the authors in the correct order here, however, please make sure they are listed in the correct order in the abstract submission box).
Author 1 Name*
Author 1 Email*
Author 2 Name
Author 2 Email
Author 3 Name
Author 3 Email
Author 4 Name
Author 4 Email
Author 5 Name
Author 5 Email
Author 6 Name
Author 6 Email
Author 7 Name
Author 7 Email
Author 8 Name
Author 8 Email
Author 9 Name
Author 9 Email
Author 10 Name
Author 10 Email
Type of Abstract*
If you selected "Other", please describe below:
Presentation/Poster Title*
Will you have multiple presenters?*
Please enter the names and email addresses of other presenters.
- Your abstract will be published in the abstract booklet as it appears below. All abstracts must be formatted as follows (please note that author names do not count against the character limit):
For Scientific Research: Authors' names (ex. Smith, JL), Background & Hypothesis, Methods, Results, Conclusions

For Clinical Cases: Authors' names (ex. Smith, JL), Case, Conclusions, Clinical Significance
Abstract

Please enter your abstract below. Once submitted, your abstract cannot be altered in any way and will be published as typed.
Author Names: Please remember to place the author names in the correct order/in the order they will appear on your poster (e.g. the primary author is listed first, etc.), followed by your abstract text.* Example: Jones K, Silverman VM, ....*
Abstract: Please limit your abstract text to ≤2000 characters (Author names DO NOT count as part of your character limit.). If graphics are included, please deduct 250 characters.*

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Agreement and Electronic Signature

By submitting this application, I affirm that I will be available to present at the MWIA Centennial Congress. I affirm that I have reviewed the application instructions and that the facts set forth here are true and complete. I also acknowledge that my $40.00 abstract fee is required to participate, and that it is non-refundable in the circumstance that I am unable to attend. I understand that an email has been sent to each of the authors listed with notification of my submission.
Signature (Electronic)*
YOUR SUBMISSION AND PAYMENT ARE NOT COMPLETE UNTIL YOU CLICK THE SUBMIT BUTTON BELOW:
Should be Empty:

MWIA Centennial Meeting

Personal Information

Abstract

Agreement and Electronic Signature