10-13 December 2018
|
Abuja, Nigeria
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ASLM Admin
2021-06-14T12:58:36+00:00
ASLM2021 Satellite Session Application Form
ASLM2021 Satellite Session Contact Person
Contact Name
*
Please enter the first and last names (or 'name'). This is the contact for organizing logistical items related to the seminar and will be contacted for proofing of marketing materials.
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Contact Email
*
Contact Phone
*
ASLM2021 Satellite Session Information
Seminar Type
*
Please select the type of seminar you are requesting.
Morning (1 hour)
Evening (1 hour)
Requested Seminar Date (select one)
*
16th
17th
18th
Requested Seminar Time (select all that apply)
*
7AM-8AM GMT
8AM-9AM GMT
6PM-7PM GMT
7PM-8PM GMT
Closed (Invited Guests Only) or Open To All
*
Invited Guests Only
Open To All
Seminar Title
*
The following will be published in all marketing materials.
Seminar Description/Abstract
*
There is a 5000 characters limit for the description to be posted on the ASLM2021 website.
Target Audience (e.g. medical technicians/scientists, diagnostic suppliers)
*
Learning Outcomes
*
Organisation/Sponsor Logo Upload
Please upload an image file of your logo for publishing on the ASLM2021 website
Company host/sponsor
*
The following will be published in all marketing materials.
Comments and Questions
If you have any additional comments or questions, please share them below
Speaker / Presenter Information
Please provide the requested information on each speaker as you would like it to appear in the conference marketing materials.
Speaker/Presenter (1)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
*
Organisation
*
Speaker/Presenter (2)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
Speaker/Presenter (3)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
Speaker/Presenter (4)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
Speaker/Presenter (5)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
Speaker/Presenter (6)
Speaker/Presenter Name :
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
Speaker/Presenter (7)
Speaker/Presenter Name ;
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Title
Organisation
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