Application for an Educational Event in Association / Supported by ISUCRS

Name of applicant*

E-Mail Address*

Phone number (including international Country Calling Codes)*

Application for:*

Is the application on behalf of any local or national organization?*

City and country where the meeting is to be held.*

Suggested dates of meeting*

Are these dates coinciding with any major local/national/international meeting attracting colorectal surgeons?*

Will the meeeting be sponsored by any university/medical school? (If Yes - endorsement should accompany this form)*

Endorsement Form (see above)*

Please provide details of the meeting venue*

Detail the possibilities to finance the meeting (including availability of resources to promote a meeting).

Do you have well organized supporting group which can devote enough time for the organization of the meeting? Please detail.

What other support is offered by scientific or governmental authorities?*

What support would you like from ISUCRS?*Advertise the meeting on ISUCRS website?‎ (All Events)Advertise the meeting in an e-flyer from ISUCRS?‎ (All Events)Provide speakers for the meeting?‎ (Only ISUCRS Lead Event)Assistance in creating the programme?‎ (Only ISUCRS Lead & Supported Events)

Date*

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Application for an Educational Event in Association / Supported by ISUCRS

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