Events endorsement application

Hospital / Institution

Course / event title:

Starting date

End date

Location / venue

Address

Postcode

City

Country

Course contact details

Title

First name

Last name

Phone

E-mail: for information & registration

E-mail address cc

Course / event website

Upload the events web banner for publication on our event calendar

Faculty list: List all the faculty announced in the programme. Please upload a list to include: title (Dr. Prof etc), first name, last name, indicate if EAES member-Yes or No

Short CV director (s) including a list of publications

Program: to include a short course description: Target group, minimum suggested skills, number of participants, objectives, resources, accreditation, hands-on activity, registration fees etc...

Budget overview

I authorise the European Association for Endoscopic Surgery to obtain information from any source regarding this application.
I hereby certify that the above information is correct and is given in good faith.
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Events endorsement application

Course contact details

Assessor