PHOTOMEDICINE SOCIETY ANNUAL MEETING
ABSTRACT APPLICATION FORM

 

This form must be completed and submitted with your formatted abstract. Abstracts can be submitted via (i) MAIL/COURIER, or (ii) ONLINE via Email attachment.  Applications are due:  December 4, 2009.

Submissions are considered incomplete
unless both the formatted abstract and this application form are submitted.

Title of abstract:


     

 

Corresponding Author:

Name

     

Address

     

 

     

 

     

 

     

Telephone no.

     

Fax no.

     

Email address

     

**Presenting Author:__________________________________________________________________________________________________

ALL ABSTRACTS ARE ORAL PRESENTATIONS.

Does the abstract qualify for the best presentation award by a resident/fellow/student (the first author and presenter should be a trainee)?
If so, do you wish to compete for this award?

Yes

No

 

     
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