Abstract Form

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	Velo-Cardio-Facial Syndrome Educational Foundation, Inc.

Abstract Form for All Submissions:
Must be submitted online by 11:59 PM EST, April 15, 2012

19th Annual International Scientific Meeting, July 19-22, 2012
The Velo-Cardio-Facial Syndrome Educational Foundation, Inc.
Toronto, Canada

Abstract Title: (Required)

Submitted By:
Title:

First Name (Required)

Last Name (Required)

Full Names of All Authors: (Required)
1. 2. 3. 4. 5.

Type of Presentation (check appropriate category): (Required)
Professional paper (up to 15 minutes*)
Professional Seminar (up to 30 minutes*)
Lay Presentations: Personal Perspectives (5-10 minutes)
Poster session
Other:

TIME REQUESTED FOR PRESENTATION* (if different):
(*Actual time allocated will be determined by the Program Committee)

Telephone:
Country Code: (if outside US)

Area Code:

Phone Number: (Required)

Fax:

Name of Institution: (Required: enter "none" if not affiliated)

Street: (Required)

City:

State:

Zip Code:

Country:

Email: (Required)

Authors/Presenters: (Both Required)
I am aware that my handout (in pdf format) must be submitted by JUNE 30, 2012 for inclusion in the handout book.

I agree to submit a glossary of approximately 10 TERMS and their definitions as intended in my presentation by June 30, 2012. (mandatory)

Please check the boxes below as appropriate:

Select one: (Required)
I give permission for the VCFSEF, Inc. to audio record this presentation
I do not give permission to record

Select one: (Required)
I give permission to post my presentation on the VCFSEF website and will provide a copy by July 15, 2012.

If my presentation as shown at the conference cannot be posted for any reason, I will submit an alternative version by July 15, 2012 or you may post my handout.

I do not give permission to post any version of my presentation or handout.

All abstracts must be submitted online at www.vcfsef.org no later than 11:59 PM EST, April 15, 2012. (Required)
Insert abstract text here.

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