Child Neurology Society 2009

(With Title and Institutional Affiliation)

(As it will be published, if accepted)

Please enter brief (1-2 sentence) statement of educational objective(s) for the symposium, i.e., what specific knowledge, attitudes or skills will the participants acquire?

List proposed speakers. Include institutional title and affiliation.

Speaker 1:

Speaker 2:

Speaker 3:

Speaker 4:

Additional Comments:

Could this symposium be appropriately considered as a corporate-sponsored satellite symposium?

If 'yes', please list potential sponsors and any relationships you may have with them that would be helpful in soliciting financial support.

What specific format/strategies do you intend to use to accomplish the above objectives (e.g., Workshop? Lecture update on standard treatment, new insight into disease, new therapies, etc.)?

What is the intended learner/audience level?

If yes,when and where? Please list other topics/speakers presenting with you.

Please indicate any potential conflict or redundancy between your proposed symposium and past CNS Annual Meeting symposia (past five years)

(Assume 800 total meeting attendees)

Comments:

Time block requested for your symposium?

List any potential financial or other conflicts of interest. (Note: If your proposal is accepted, a full, signed financial disclosure form will be required from all presenters)

List any corporate or non-profit/government grant sources with which you have an established relationship that may be willing to provide an UNRESTRICTED EDUCATIONAL GRANT in support of your proposed symposium.

Proposals not selected for presentation may be forwarded to a CNS Special Interest Group (SIG) for possible inclusion in the SIG session scheduled at the CNS Annual Meeting. If interested, please select SIG to which your proposal may be forwarded.