Request for ACEP Endorsement of International Conference

Important: Read our Operational Guidelines for ACEP Support of International Meetings.

Date Submitted

Conference Start Date

Conference End Date

Conference Title

Conference Website

Conference Location:

Full Venue Name

City

State/Province

Country

Postal Code

Primary Planning Organization

Conference Secretariat Information

Name (First & Last)

Phone

Fax

Email

Registration Location Information

Address

City

State/Province

Country

Postal Code

Phone

Fax

Requestor Information

Name (First & Last)

Title

Address

City

State/Province

Country

Postal Code

Phone

Email

Anticipated Number of Participants

Target Audience

Do you have any documents to share with your request?

Examples:

Promotional Brochure
Conference Time Schedule
Conference Goals
Statement of Summary Showing Conference has Significant Education Value
List of Other Sponsoring Organizations

Upload Your Document(s)

Documents accepted: PDF, DOC, DOCX

Name of ACEP International Section Member Participating in Conference Planning

Send Your Request

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