Fill out this form for the request.
Fill out this form for the request
Title of the activity requesting AVAL
Entity, owner or person and affiliation requesting the guarantee
Person and affiliation of the person making the request
CONTACT PERSON Phone Email
TYPE OF ACTIVITY (if there are several related activities/events, state it in comments/allegations)
Printed: BookBrochureAdvertisingOther
Computing: CD o DVDWeb PageBibliography
Courses: Face-to-faceOn-lineCongress / Scientific Meeting
General description:
Event date: From to
Place of the event:
Scientific program:
Who is it for?:
Do you have official Continuing Education Accreditation? YesNoRequested
Do you have the Endorsement of another Scientific Society, University or College of Physicians? YesNoRequested Please indicate which ones:
Is an AAD Partner/s the promoter/organizer of the EVENT? YesNo Name/s:
Is the Promoter/organizer an institution, entity or industry with commercial purposes? YesNo Name/s:
Do you request to be advertised by the AAD on the website? (ADDITIONAL COST) YesNo
Do you request to send 2 emails to AAD members? (ADDITIONAL COST) YesNo
Do you request the sending of ordinary mail to AAD members? (ADDITIONAL COST) YesNo
Do you request the creation of a banner on the first page of the AAD? (ADDITIONAL COST) YesNo
Do you have sponsorship or participation of any commercial house? YesNo Number of commercial houses: Commercial houses:
Economic report of the event is attached (essential) YesNo
Comments or allegations:
Letter is attached YesNo
Shipping date:
Δ
