ISMRT Chapter/Division Meeting Proposal Form

Proposed Meeting Details

Submitter's Details:

Submitter's Member ID Number*

Submitter's Email*

Submitter's Institution*

Details of Other Key Members of the Organizing Committee:

Proposed Date Range:

1st Date Choice - Start*

1st Date Choice - End*

2nd Date Choice - Start*

2nd Date Choice - End*

Time

Please input the start time in UTC time zone

For which Division or National Chapter is this meeting proposed?*

Total number of education hours to be included in your proposed meeting:*

Proposed meeting title:*

ISMRT Meetings with ISMRM/ISMRT Central Office Administrative Support

Below is a list of services the Central Office provides. Please select the services you require:

Please note to facilitate the above, speaker materials and registration information must be received at least 45-days prior to the meeting date. Each speaker will be contacted and will be required to submit the following information:

• Confirmed Talk Title
• Confirmed Talk Objectives
• Speaker Financial Disclosure form (Speaker(s) & Moderator)
• Summary CV/Resume
• Current Photo/Headshot

Proposed Meeting Budget

Please complete the budget details in the following Excel template for your proposed meeting:

Download Preliminary Budget Template Here

Upload Preliminary Budget File*

Preliminary budget will be available to update as meeting plans progress, and after meeting is completed through the ISMRT Central Office

Accepted file types: xls, xlsx, Max. file size: 24 MB.

Proposed Speaker and Moderator Details

Please complete the following speaker and moderator details for your proposed meeting.

Overview*

Minimum 100 words

Upload speaker CVs*

Drop files here or

Max. file size: 24 MB.