Table clinic application 2019

The Projected Clinic Application to be presented on Friday February 22, 2019 from 2:00 to 4:30 PM at the Drake Hotel, Chicago, IL.

Deadline for receipt of applications is October 15, 2018.
If accepted for presentation, you will be provided with a private invitation to register for the meeting. Acceptance notifications will be made by November 1, 2018

The Academy will accept only 12 clinics, four of which will be in the format of sit-down clinics. The Academy encourages applications in this category. The format of the sit-down clinics will be a 20-minute lecture organized in a concise manner so that it may be repeated for multiple small groups. The remaining table clinics will be furnished an appropriately draped table (size).

Please fill out the application form below:

Degree(s)
 DMD  
 DDS  
 BDS  
 BDent  
 MSc  
 MSD  
 MMSc  
 MDent  
 MDS  
 DDSc  
 DScD  
 GPR  
 Zahnarzt  
 PhD  
 Certificate  
 Diploma  
 Other:  
The Academy cannot provide any computer or LCD/video support.
Lap top computer presentations relying on computer screens alone are not acceptable as viewing would be unsatisfactory for attendees. Pre-recorded soundtracks are not approved for use in an Academy Table Clinic Programs. If you will be presenting a poster type presentation, make certain that the content is large enough for attendees to see and read.
Presentation format:
 Sit Down Clinic  
 Table Clinic or Poster Presentation  
 Screen Needed for Projector  
 Electrical Connection  
 Draped Table  
 Poster Board  
 Other:  
    

In appreciation for your willingness to contribute to the Academy’s Program, the Academy will provide one complimentary registration per Table Clinic. Co-presenters will be required to pay the appropriate registration fee. The Academy will meet on February 21-22, 2019, a The Drake Hotel in Chicago, IL. Table Clinics will be presented on Friday, February 22, 2019, from 2:00 – 4:30 PM.

Please return this application at the earliest possible date as proposed table clinics will be considered for acceptance according to the needs of the program and the date of receipt of the application. Fiduciary statements will be sent to clinicians after acceptance. Table Clinics representing or advertising a commercial company, product, or continuing education course will not be accepted.