Joint Sponsorship Application



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AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS JOINT SPONSORSHIP APPLICATION APPLICANT INFORMATION Organization Name: Meeting Name: Meeting Dates: Meeting Facility: City, State: CME Contact (must be a neurosurgeon): Address: City: State: ZIP Code: Telephone: Fax: Email: Administrative Contact (if applicable): Telephone: Fax: Email: WEBSITE CONTACT INFORMATION Your meeting will be posted on the AANS Meetings Calendar on the AANS website (unless you advise otherwise).. ☐Previous evaluation results ☐Survey of target audience ☐Medical literature review/Journal articles ☐Outcomes data ☐Expert opinion (as documented in meeting minutes, emails, etc.) ☐Program committee/board consensus (as documented in meeting minutes) ☐National and/or specialty guidelines ☐Local, regional, state or federal/national statistics ☐Other (describe) Educational Content Planners: List all individuals who are involved in the planning of your scientific program (you must list these individuals in your final program and collect disclosures from them): Physician Attributes: Please check ACGME/ABMS or IOM competencies (the physician attributes) that are associated with the meeting content..




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