Endorsement Application

ENDORSEMENT APPLICATION

    Educational Meeting Title:

    Dates:

    Chairman/Co-Chairmen and Board Certification[s]:

    Organization Seeking Endorsement:

    Address:

    Primary Contact Person:

    Primary Contact Email Address:

    Website:

    Please provide a short abstract of the planned meeting:

    List the meeting’s goals and objectives:

    List the faculty (If not plastic surgeons, facial plastic surgeons, or otorhinolaryngology surgeons, list specialty):

    To what other organizations have you applied for endorsement?

    Has your application for endorsement been accepted?YesNo
    If yes, which organizations:

    To what medical specialties will this educational activity be marketed:

    The undersigned, in consideration of being designated Chairman or Co-Chairman of the aforementioned meeting, acknowledges that:

    • he/she has read, understands, and agrees to abide by each of the Policies for Endorsement;
    • an endorsement fee of $500 USD will be paid to the Rhinoplasty Society 60 days before the meeting;
    • copies of all promotional materials will be sent to the Rhinoplasty Society.

    Signed:

    Please upload the program and/or advertisements, if available (zip, pdf, doc, docx, jpg, gif, or png formats):
    File 1:
    File 2:
    File 3:

    CLICK BELOW TO SEND TO THE TRS EXECUTIVE OFFICE