ABSTRACT SUBMISSION FORM
CORRESPONDING AUTHOR AND CONTACT DETAILS
Maintaining Challenges in Medical Practice, Family Medicine and Education
21 - 24 August 2010, London, UK
1. TITLE:
2. FIRST NAME:
3. SURNAME:
4. ADDRESS
POST CODE:
EMAIL:
TEL:
FAX:
MOBILE PHONE:
5. NAME OF ORGANISATION:
6. NAMES OF AUTHORS (Please note you can list as many authors as possible provided they participated in the production of the work):
1.
2.
3.
4.
7. PRESENTING AUTHOR(S):
8. ABOUT THE ABSTRACT:
We confirm that the abstract has not been published elsewhere.
The abstract has been published elsewhere and written copyright permission is attached.
We prefer the abstracts to be considered as a:
Paper/presentation
Poster
Demonstration
9.PRESENTATION FORMAT:
Projection requirements for presentation if accepted:
OHP
Video
CD
DVD
Data projector
Bringing own laptop
Required laptop
Slide projector (PowerPoint Slides)
Internet connection
10.TITLE OF ABSTRACT:
11. ABSTRACT:
I release copyright of this abstract with consent and authority to the organisers of this conference for the abstract to be published in the Book of Proceedings and deposited in the United Kingdom Legal Deposit Box for safe keeping and future reference. (Please note the presenting author or the researcher must sign number 14 and 15 below to enable the abstract to be published in the Book of Proceedings).