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: announcement on WABIP website, Newsletter and Facebook page, delivery of electronic Bronchoscopy Education Project learning materials upon request, and consultation regarding scientific program content as needed.

There is no financial cost to organizers by gaining our program endorsements. Please note, however, that such endorsements do not provide any financial support to programs or their related events.

Please fill out your information below. Required fields are denoted by "*".
  1. Name of Applicant: *
    Please type your full name.
  2. Email Address: *
    Invalid email address.
  3. WABIP Member Society (optional):
    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 (optional):
    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. Upload the scientific program (preliminary or finalized): *
    Must upload at least one file.
  14. Upload image of your brochure, flyer or other marketing materials:
    Must choose file
    (optional, JPG or PNG file type only)
  15. Website address (optional):
    Please type the title.
  16. Additional information or comments (optional):
    Invalid Input


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