APPLICATION FORM FOR FINANCIAL ASSISTANCE (WABIP COSPONSORSHIP) OF BRONCHOSCOPY EDUCATION PROGRAMS

Applications are due by APRIL 30, 2023 for courses/workshops held between October 1, 2023 and October 1, 2024.


MAIN ORGANIZER
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PROGRAM DETAILS
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Please type the title.
Please type the location.
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Please include Learning Objectives.
Please include Learning Objectives.
Please include Learning Objectives.
Please include Learning Objectives.
Please include Learning Objectives.

BUDGET
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AGENDA
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Must choose one.
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AGREEMENT

By providing my electronic signature below and submitting this application form, I hereby confirm and agree that:
  • The WABIP may request from applicant further details regarding program such as additional budgetary information or faculty member lists.
  • The WABIP reserves the right to amend the terms and/or conditions of this financial support offering.
  • The WABIP reserves the right to reject this application for any reason.
  • The WABIP logo will be inserted into all marketing materials (website, flyers, banners) of this program.
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