Program Endorsement

Application for Program Endorsement

This online form is to apply for official WABIP endorsement of your scientific/educational program, seminar, workshop, or conference.

Benefits of endorsement include:

  1. Announcement on WABIP website, Newsletter, Facebook page and Instagram
  2. Delivery of electronic Bronchoscopy Education Project learning materials upon request
  3. Consultation regarding scientific program content as needed
There is no financial cost to organizers by applying for or obtaining WABIP program endorsements. Please note that the WABIP is in under no obligation to provide any financial support to organizers, programs or events, as a result of obtaining WABIP endorsements.

Please fill out your information below:

  1. Name of Applicant: *
    Please type your full name.
  2. Email Address: *
    Invalid email address.
  3. WABIP Member Society:
    Please type your full name.
  4. Program Title: *
    Please type the title.
  5. Program Director:
    Please type your full name.
  6. Program Date: *
    Please type the date.
  7. Program Location: *
    Please type the location.
  8. Program Type (select all that apply): *
    Invalid Input
  9. Major funding sources: *
    Invalid Input
  10. Other potential sponsors:
    Invalid Input
  11. Are Continued Medical Education credits (or equivalent) being offered? *
    Must choose one.
  12. Will you consider Bronchoscopy Education Project resources to be used in this program? (resource downloads here) *
    Must choose one.
  13. Learning Objectives: *
    Invalid Input
  14. Upload the scientific program (preliminary or finalized): *
    Must upload at least one file.
    (Required. File size = 5 MB max limit)
  15. Upload image of your brochure, flyer or other marketing materials:
    Must choose file
    (Optional. JPG, PNG or PDF file type only)
  16. Website address:
    Please type the title.
  17. Additional information or comments:
    Invalid Input


    As a condition of WABIP endorsement of this program, I hereby agree that:
  19. (Must check all boxes) *
    Must check all boxes
  20. Signature: *
    Please type your signature.
  21. Click: *