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1. Applicant's name
Last name,first name - eg. Smith, John *
Please enter applicants name
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2. Hospital/Institution *
Please enter hospital institution
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3. Preferred email address *
Please enter email address
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4. Preferred mailing address *
Please enter mailing address
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5. Preferred phone number *
Please enter phone number
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6. Declaration of Interest
Please choose one *
Please enter declaration of interest
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Section Two: Abstract Details
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7. Title of project
In CAPITALS *
Please enter title of project
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8. Author(s) / Presenter(s)
Surname and initials only - eg Smith J Y. Presenter's name in CAPITALS
Do not include titles, degrees or awards *
Please enter authors name
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9. Are you an invited speaker? *
Please enter invite type
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10. Presenter's Biography
To be used in Session Chairman's introduction *
Invalid Input
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11. Institution(s)
1-4 centres where the work originated
Give only institution name and city - eg Westmead Hospital, Sydney *
Please enter institution
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12. Paper Type *
Please enter paper type
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Poster
13. Is the work suitable for a poster presentation? *
Please enter poster presentation status
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14. Would you accept a poster position if the application for podium presentation is not successful? *
Please choose poster position
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15. Presentation
Please choose the category you would like to present in: *
Please choose category to present in
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16. Body of Abstract
Maximum 400 words, excluding headings but including referencesDo not include graphs or diagrams
Use abbreviations only for common terms; for uncommon terms give abbreviation in brackets after first full use of the term. *
Please enter body of abstract
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17. Confirm wordcount - must not exceed 400 words
Body of abstract only, excluding heading and including references *
Please confirm wordcount
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18. Recording
All presentations will be recorded for publication either on DVD or on the internet, for educational purposes only, unless you choose to exclude your presentation.
Do you consent to the recording of your presentation being published? *
Please fill in consent to presentation publishing
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Security Code *
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