Download 2. Being a speaker/author in AEEDC Dubai World Orthodontic 2017

AEEDC Dubai World Orthodontic 2017
Conference
5 - 6 February 2017
Dubai International Convention and Exhibition Centre
Conference Lecture Abstract Form
Deadline: 14th August 2016
For office use only
Please complete and submit this form to:
INDEX Conferences & Exhibitions Organisation Est.
P.O. Box: 13636, Dubai – United Arab Emirates
Tel: +971 4 3624717, Fax: +971 4 3624718
E-mail: [email protected]
Date Rcvd. ______________________
Reg. No. ________________________
Abs. No. ________________________
Speaker’s
Name:
Co-author
Name (if
applicable):
Title:
Prof.
Dr.
________________________
Accelerated Orthodontics
Cleft Lip and Palate: The Orthodontic Aspect
Functional Appliances
Imaging : Old and New
Orthodontic Aligners
Surgically Assisted Orthodontics
Temporary Anchorage
Other ,please specify----------------------------------------------
Presentation
Field:
Sector:
Other, please specify
UAE
GCC & MENA region
International
Academic
Private
Other, please specify
________________________
Degree:
( e.g. :MSc.
FDS RCS, PhD,
FHEA )
Current
Position:
Short
Biography:
(Maximum 40
words)
CV:
Kindly attached your full CV
Photograph:
(passport size)
Kindly attached your recent photograph:(High resolution)
Format: JPG or pdf
Resolution:300dpi
File size: more than 1mb
Presentation
Title:
(Maximum 20
words)
Abstract: (Maximum of 100 words)
Introduction: (Maximum of 200 words)
Learning Objectives: (5 Objectives required. These should also be in your
presentation)
Presentation Slides:
Presentation Slides” outline is mandatory for the accrediting of any lecture.
Kindly find the below guidelines for your perusal:
 You may send the presentation in the following formats: word document, or
power point.
 The submitted presentation title and the actual sent presentation should be
identical.
 The lecture content should not be of commercial nature ( no endorsement for
any specific commercial drugs, materials, products, treatments, or services)
 Acknowledge the speaker sources by citing the references in last slid of
his/her presentation slides.
 Please honor all patient privacy and rights in regards to photos within the
submitted presentation, note that this might cause denial of accreditation
process.
The accreditation bodies may request further information or documentation on a case by
case basis and both AEEDC Dubai World Orthodontic 2017 Conference and the
speaker are obliged to comply.
Literature
Review :
Provide at least three literature references in relation to your
presentation. (Acknowledge the speaker sources by citing the references
in last slid of his/her presentation slides)
Who should attend your lecture?
General Practitioners
Expected
duration:
Specialists
30 minutes
45 minutes
60 minutes
For Joint Lectures:
90 minutes
120 minutes
Note:
Have you
previously
presented any
lecture /course
in any regional
/International
events?
Yes or
No
If yes, please specify the name of the event.
Note:
Please provide information if this lecture has been presented previously or planned to be
presented before AEEDC Dubai World Orthodontic 2017 Conference?
If yes, please specify:
Your Contact Information
Organisation:
Tel:
Mob:
Fax:
Email:
Address:
Abstracts not complying with the specified format will not be considered.
Abstract Submission Guidelines:
*(The term organiser means INDEX Conferences & Exhibitions Organisation Est.)
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Abstract should not exceed 100 words. The abstract must be in English, font size
12 in Times New Roman fonts and with single-line spacing.
Abstracts should be submitted by e-mail. Abstracts that are handwritten, or sent
by fax will not be accepted.
Abstract content must meet the standard of an academic / scientific presentation.
In cases of research or clinical study, the abstract must be based on the original
research or original clinical case studies, or their modifications.
The AEEDC Dubai World Orthodontic 2017 Conference Scientific
Organising Committee will evaluate the content of each abstract and make the
final selection of the abstracts for presentation.
The presentation must cover the same material as the abstract.
If the abstract has been selected for presentation the speaker automatically gives
permission for the abstract published in the conference program or to any postconference announcement.
Optional: Would you agree to upload your presentation or a recording of your
lecture on the event’s website?
Yes
No
No abstracts will be considered after 14th August 2016.
For any withdrawals, the speaker should notify the *organiser in writing as soon
as possible or minimum of 2 months prior to the event.
Any particular equipment and materials which is necessarily to conduct the
session is be declared to organiser and approved to be obtained latest by the
submission of the presentation.
P.S: Please respect the deadline for presentation submission (1st of October
2016) delay in submission the presentation will result in delay on CPD
accreditation and possibly in cancellation the session.
For AV preparation, the below will be provided during conference presentation:
 Projection Screen size: 3:1
 LCD Projector – 15000 ANSI LUMENS
 Laptop
 DVD player (in case of movies)
 Audio System and Speakers
 Podium Microphones
 Headset Microphone or Lapel Microphone
 Laser pointer.
 Clicker remote
P.S: Special requirement and specifications need to be requested and reconfirmed with
the organiser before 1st of October 2016.
Disclaimer Statement
In order to maintain efficiency, the following disclaimer should be signed and
understood, informing both the Speaker/Author and *Organiser/Event responsibilities.
1.
I understand that the submission of an abstract does not automatically entitle me
to participate in AEEDC Dubai World Orthodontic 2017 Conference neither as
a speaker nor as a participant.
2. Being a speaker/author in AEEDC Dubai World Orthodontic 2017 Conference,
I undertake to complete and submit any other disclosure statements required by
any other organisation, including the conference organiser, in relation to my
participation in AEEDC Dubai World Orthodontic 2017 Conference, and I
guarantee that the disclosure statement will be complete and truthful to the best of
my knowledge.
3. I have made every effort to guarantee the accuracy of the information supplied
within the Abstract Form, and disclaim all warranties with regards to the
information included on the Abstract Form without limitation.
4. I fully understand that AEEDC Dubai World Orthodontic 2017 Conference will
not be held responsible for any errors or omissions in the information provided in
this form.
5. I understand that I will be solely responsible for my presentation, equipment such
as hard disk, flash memories, CDs, DVD, laser pointers, portable computer devices,
etc. and that AEEDC Dubai World Orthodontic 2017 Conference takes no
responsibility, and disclaims any liability, for any personal equipment in regard to
my presentation.
6. I guarantee to not conduct any CME events (Conference, Courses, Seminars,
Symposiums, Demonstrations, Workshops, etc.) 30 days before, or 30 days after
the AEEDC Dubai World Orthodontic 2017 Conference in United Arab Emirates
unless agreed with organiser.
7. I guarantee to not conduct any CME events (Conference, Courses, Seminars,
Symposiums, Demonstrations, Workshops, etc.) on similar or the same
topic/subject/title 3 months before, or 3 months after the AEEDC Dubai World
Orthodontic 2017 Conference in United Arab Emirates unless agreed with the
organiser.
8. I understand that I need to have travel insurance and the *organisers are not
liable for any emergency related to travelling to the event.
9. I understand that in case accepted to lecture at AEEDC Dubai World
Orthodontic 2017 Conference, the *organisers cannot guarantee specific time
or date and program slot for my speech, and that last minute program changes are
possible due to unforeseen circumstances and are accepted by me.
10. I understand that if accepted to present at AEEDC Dubai World Orthodontic
2017 Conference, I have to provide my presentation (soft version) at least one
month before the announced date of the presentation.
11. I understand that photos will be taken during my presentation for marketing
purposes.
12. I understand that it is my responsibility to inform my presentation attendees of any
hazards risks involved in the clinical application of the information presented
without sufficient education, training and/or supervision.
13. I, the undersigned, declare that neither I, nor any member of my family has any
financial arrangement or affiliation with any corporate organisation offering
financial support for this continuing dental education programme, nor do I have a
financial interest in any commercial product(s) or service(s) discussed in the
presentation.
a. If yes, please state the name of the organisation and the kind of affiliation:
14. I understand that any handout materials to be distributed during or at the
conference/course presentation must be submitted to the AEEDC Dubai World
Orthodontic 2017 Conference Scientific Organising Committee at least one
month prior to the event for approval. Only approved handout materials can be
distributed during the conference/course session.
15. “Presentation Slides” outline is mandatory for the accrediting of any lecture.
Kindly find the below guidelines for your perusal:
 You may send the outline in the following formats: word document, pdf form
scanned copies.
 The lecture content should not be of commercial nature ( no endorsement for
any specific commercial drugs, materials, products, treatments, or services)
 Acknowledge the speaker sources by citing the references in presentation
slides.
The accreditation bodies may request further information or documentation on a
case by case basis and both AEEDC Dubai World Orthodontic 2017
Conference and the speaker are obliged to comply.
16. I understand that incomplete form will not be accepted as all required information
should be received before the submission deadline.
By signing this statement, I declare that the mentioned terms and conditions in points
from 1 to 16 in the disclaimer statement and the guidelines for abstract submission
and presentation are understood and accepted, and will be complied with and
maintained.
Signature:
Date: