Application Form for a SIOG session
Applicants Details
Title and brief description of event______
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Name and address of organization responsible for the event______
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Name of person to contact in relation to this application______
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Tel. ______Fax. ______Email______
Name of person responsible for this event______
Tel. ______Fax. ______Email______
Venue address______
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Event date(s)______Event Website link______
Number of expected attendees______
Approximately what percentage of audience will beLocal_____Regional______National______International____
Please indicate if this event will provide CME credits Yes□No □
If yes, from which organisations: 1. ______2.______
3.______
Session Details
Session Main Title______
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Name of Chair 1______
Name of Chair 2______
Speaker 1______
Title of Presentation 1______
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Speaker 2______
Title of Presentation 2______
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Speaker 3______
Title of Presentation 3______
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Speaker 4______
Title of Presentation 4______
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Speaker 5______
Title of Presentation 5______
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Speaker 6______
Title of Presentation 6______
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Please note that the chairs and speakers of this session must be SIOG members.
Please note that one of the speakers/chairs must add a slide about SIOG in general and the SIOG conference into his/her presentation
Please indicate whether you agree to thisYes □No □
Please note that you must agree to provide SIOG with the slides/webcast of thissession
Please indicate whether you agree to thisYes □No □
Application procedure
1. Completed applicationsmust be received 3 to 5 months prior to the event. English-language translation must be provided if the program is written in a non-English format (this is so the committee members can review)
2. A copy of the educational program, in English, must be submitted with this application. Please note that the subject of the event falls within the scope of SIOG Mission and Strategic Objectives
3. The slides/webcasts of the session must be provided to SIOG. The content provided will be published on the SIOG website as an educational resource. Permissions from authors should also be provided.
4. The event does not carry any tobacco or alcohol related advertising
5. The SIOG Logo with the specific mention “SIOG Session” must be placed next to the programme of the session
6. The SIOG Logo should be used in compliance with the SIOG logo policy listed on the next page.
7. The Chair should send a brief post-event report (5-10 lines) and pictures (if available) to the SIOG Head Office 30 days after the event.
International Society of Geriatric Oncology Logo Policy
The International Society of Geriatric Oncology (SIOG) logo, and other SIOG event logos, may only be used for the purpose specified upon written consent from SIOG.
If you wish to use the International Society of Geriatric Oncology (SIOG) logo, please contact the SIOG Head Office for application materials and permission to reproduce the logo.
With written permission from the International Society of Geriatric Oncology (SIOG) Head Office, the SIOG logo may be used in marketing collateral, product announcements, reports, published articles, and advertising copy in print and on the Web.
The SIOG logo must be used in the proper form (as shown below):
Colors references
C66, M44, J0, N0
PANTONE 7456 C
R123 | V137 | B198
□ I, the undersigned, verify that I have read the aforementioned application procedure for awarding of the SIOG auspices and the SIOG logo policy, and that I agree to abide by these criteria.
Signed______Date______
(individual responsible for the event)
Send to by email or fax
International Society of Geriatric Oncology (SIOG)
1-5 Route des Morillons, PO Box 2100
1211 Geneva 2, Switzerland
Tel: +41 22 552 33 05Fax: +41 22 552 33 06
Email:
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